Expansion of Medicaid

In: Other Topics

Submitted By chinnd
Words 2326
Pages 10
Expansion of Medicaid

On March 23, 2010, President Obama signed the Affordable Care Act (ACA) into law, allowing all Americans access to affordable health care. Despite the urgent need to provide health care to all Americans some Governors and elected Congressmen continue to debate over the necessity to expand Medicaid and the ACA. The Supreme Court on June 28, 2012 ruled in support of the ACA by upholding the individual mandate which require Americans to have health care insurance. Americans without health care insurance, because of this new health care policy will be able to either purchase insurance through the exchange market or through the expansion of Medicaid. Some states are against the expansion of Medicaid even though the government will fund 100% of the program for the first 3 years. The states that decide to opt out of the Medicaid expansion will heap some negative impact on several stakeholders. The ultimate goal of the ACA and the expansion of Medicaid was to provide quality health to the many uninsured.

Expansion of Medicaid The implementation of an important component of the Affordable Care Act (ACA) is the expansion of Medicaid. The expansion of Medicaid ensures health care coverage for children, poor people, disabled people and some elderly citizens. Unfortunately, 20 states have decided to opt out of this policy leaving access to health care unavailable to millions of needy people. It remains unclear why so many governors and congressmen dislike the expansion of Medicaid and the ACA in its entirety. The impact of not implementing the expansion of Medicaid leaves many Americans uninsured as well as a tremendous burden on our economy. Communities have and will continue to struggle to address the health of its citizens without this expansion. Politics has played a major role in disqualifying the policy…...

Similar Documents

Medicaid Programs

...Medicaid Programs By: S. Nichole Sewell AJS/522 - FINANCE AND BUDGETING IN JUSTICE AND SECURITY Instructor: HENRY PROVENCHER Medicare is a national social insurance program, administered by the U.S. federal government since 1965, which guarantees access to health insurance for Americans ages 65 and older and younger people with disabilities as well as people with end stage renal disease (Medicare.gov, 2012). Medicare is a program that offers everyone a well defined benefit that includes different hospital parts. The Medicare parts are: Part A, Part B, Part C & Part D. Part A is known as hospital insurance. This part covers medical necessary such as hospital stay, nursing home, home health care and also hospice care. Medicare Part A is free to people who have worked and paid in Social Security for at least 10 years. There will be a monthly premium charge if you have not worked for at least 10 years and paid Social Security taxes. Part B is medical insurance that covers things such as doctor visits, medical equipment and various other forms of other outpatient services. Part B also covers mental health care and ambulatory services. To receive the Part B medical insurance you have to pay a monthly premium. Part C is the portion of your policy that allows private insurance companies to cover your medical expenses.......

Words: 1957 - Pages: 8

Medicare, Medicaid

...Introduction The purpose of this paper is to give an overview of two federally and/or state funded programs. The programs that will be discussed are Medicare and Medicaid. In this paper will be information about who receives Medicaid/Medicare, the services offered by these programs, and those long term services that are not. Medicaid Medicaid is a joi8nt federal and state program. It provides health coverage to nearly 60 million Americans including children, pregnant women, seniors, and individuals with disabilities. As well as those people who are eligible to receive federally assisted income. Eligibility does however vary state to state. Medicaid may help pay for: Doctor bills, hospital bills, prescriptions, vision care, dental care, Medicare premiums, nursing home care, personal care services, in home care under the community alternatives program, mental health care, and services for children under 21. Medicaid can help pay for cost and services that Medicare doesn’t cover. In most states, Medicaid will pay for long term care services. In most instances they will cover services that will help and individual stay in their home such as personal care, case management, and help with laundry and cleaning. They won’t however pay for rent, mortgage, utilities, and/or food. Medicare “Medicare is the federal health insurance program for people who are 65 and older, certain young people with disabilities, and people with End Stage Renal Disease requiring dialysis or a......

Words: 708 - Pages: 3

Medicaid and Medicare Reimbursement

...Medicare and Medicaid Reimbursement for Primary Care Introduction The Social Security Act of 1965 created Medicare and Medicaid, which provides health care coverage for the elderly, poor, and disabled. Medicare has become the largest single payer health entity spending $57.9 billion in 1980, $271 billion in 2003, and $513 billion in 2010 (Social Security Administration, 2012). Whereas, Medicaid being state funded, its governance is state-specific for spending. There have been very few changes to The United States health care payment system since Medicare’s and Medicaid’s inception, until March 23, 2010, when President Barac Obama signed into law the Patient Protection and Affordable Care Act (ACA). The three main goals of the ACA are to: increase the access to health care for all Americans, increase their quality of care, and make this care affordable. Unfortunately, despite the ACA’s good intent, its scope was far reaching, glossed over current problems within health care, and created more issues. It is filled with contradictory verbiage that required multiple teams of lawyers to decipher (with many different interpretations), and changed health care reimbursement with unknown consequences. Description of Policy and the Legislation The ACA attempts to solve the reimbursement problems in several ways. The act established the Center for Medicare and Medicaid Innovation within the Centers for Medicare and Medicaid Services, which is responsible for overseeing voluntary...

Words: 1739 - Pages: 7

The Affordable Care Act and Medicaid

...The Affordable Care Act and Medicaid Albany State University Healthcare in America is the most talked about topic today. This seems to be true since the Patient Protection and Affordable Care Act, commonly known as “Obamacare”, is in place. This act was signed into law back in 2010. It took four years for the changes to take place and now citizens of America are required to have a health insurance plan in 2014. Open enrollment for “Obamacare”, insurance plans ends March 31, 2014. Those who do not have insurance by then, will be taxed 1% of their salary by the IRS or receive a tax penalty of 95 dollars. The Affordable Care Act has made many changes to health insurance coverage, such as Medicare and Medicaid, family insurance plans and more. If one cannot afford health insurance, Medicaid will be extended under certain conditions. Medicaid will be extended to individuals or families who earn up to 133% of federal poverty level. According to About.com, federal poverty level for an individual is $15,281. For a family of four, the federal poverty level is $31,321.50. Individuals or families who earn too much for Medicaid will receive tax credits only if their income level is below 400% of poverty level. According to About.com, for an individual to qualify for a tax credit, their income would have to be $45,960. For a family of four, 94,200. The credit is then applied monthly instead of a yearly tax rebate. There are also reduced copayments and deductibles for these......

Words: 1698 - Pages: 7

Cms Expansion

...heaa CMS Expansion to Bundled Payments Jimmy Lei HCS/455 July 14, 2014 AuRiesheaua Bell CMS Expansion to Bundled Payments There are many articles that discusses different issues in health care reform. Recently, an article discussed about how hospitals, nursing homes and healthcare providers are ready to join Medicare’s test of bundled payments. According to the CMS website bundled payments is defined as, “Four broadly defined models of care, which link payments for multiple services beneficiaries receive during an episode of care.” (Centers for Medicare and Medicaid, 2014) The models consists of different focuses, which include acute care inpatient hospitalization, retrospective and prospective arrangements. The idea behind bundled payment is to increase quality of care and lower costs for Medicare. The fee for service model has been scrutinized by many who believe that it has perverse incentives for organizations to not efficiently provide care. According to the article, a reported 100 organizations are currently participating in the program; however the success of the organizations are unclear. The bundled payment initiative was introduced in 2013 under the Patient Protection and Affordable Care Act as an effort to shift financing of healthcare away from paying for each procedure. The bundled payments initiative is still in its infancy, so results are not solid; however many experts and officials say that it holds promise. Currently the initiative is in the......

Words: 342 - Pages: 2

Medicaid Expansion: Dichotomous Philosophy Threatens the Economy and Health of Millions

...Medicaid Expansion: Dichotomous Philosophy Threatens the Economy and Health of Millions Medicaid is a federally funded program that insures disabled, elderly and low-income Americans. While all 50 states have yet to opt-in to its expansion per the Affordable Care Act (ACA), which would add 21 million people to its rolls, or half of the nation’s uninsured, many states chose to opt in following the June 2012 U.S. Supreme Court decision which deemed the Patient Protection and Accountable Care Act (PPACA) constitutional (AAFP)(Mears) Despite the ruling of the Supreme Court, the decision to accept Medicaid remains a divisive and heavily debated issue in many states. Indeed partisan bickering, already strained budgets and questions of uncertain monetary futures all weigh heavily upon those relegated to make the final decision of acceptance or refusal. There is also a question as to whether refusal to accept is ultimately meritorious, as acceptance necessarily requires states to agree to some future percentage of the bill while refusal renders them ineligible for millions in federal funding every year. Thus, in a way, the ACA, perhaps much like many governmental policies, could well be considered a gamble either way. Accept it now and don’t miss out on federal funding or decline it, miss out on the funding but don’t put your state on the hook for unknown quantities of money that have to come from somewhere.  The option of acceptance or refusal is indeed a very loaded......

Words: 2808 - Pages: 12

Consequences of Refusing Medicaid Expansion in Louisiana

...Consequences of Refusing Medicaid Expansion in Louisiana Perhaps the most significant of Barack Obama’s presidential achievements will be the passage of the Patient Protection and Affordable Care Act (ACA). He signed ACA, also frequently called “ObamaCare,” into law on March 23, 2010, but several milestones had to be overcome before the act went into effect in 2014. ACA was intended to increase the affordability and accessibility of quality healthcare to the American people. While these goals, at their most rudimentary form, appear to be benevolent enough, the law has been the source of many heated debates and lawsuits over the past few years. ACA was intended to use several mechanisms to increase people’s access to health insurance. (Dickman, Himmelstein, McCormick, & Woolhandler, 2014) The law called for states to set up online health insurance exchanges for people to compare and shop for health insurance policies. Individuals and families earning up to 400 percent of the Federal Poverty Level (FPL) would be eligible for a subsidy to help pay for their policy. The 2014 FPL for a family of four is $23,850. (2014 Poverty Guidelines, 2014) The law also required most uninsured people whose income exceeds 138 percent of the FPL to either purchase health insurance or be subject to penalties. Another condition called for states to offer Medicaid coverage to people with incomes below 138 percent of the FPL. This would mean a family of four earning $33,000, would make too much......

Words: 2047 - Pages: 9

Medicaid in Texas

...Medicaid is the State and Federal joint venture that provides medical coverage to the eligible individuals. The purpose of Medicaid in Texas is to improve the health of people whose income and resources are insufficient to pay for health care. The Texas Health and Human Services Commission's (HHSC) Medicaid Office is responsible for statewide oversight of Texas Medicaid. The mission of the Texas Medicaid program is to improve the health of Texans by emphasizing prevention, promoting continuity of care, providing a medical home for Medicaid recipients and ensuring that each recipient can receive high quality, comprehensive health care services within the community. (6) Medicaid serves primarily low- income families, children, caretakers of dependent children, pregnant women, cash assistance recipients, people aged 65 and older, and adults and children with disabilities. Medicaid pays for acute health care (physician, inpatient, outpatient, pharmacy, lab, and x-ray services), and long-term services and supports (home and community-based services, nursing facility services, and services provided in Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions (ICFs/IID)) for people age 65 and older and those with disabilities. Texas Medicaid provides major portion of healthcare services through managed care model. (1) There are basically four Medicaid programs in Texas. The type of coverage an individual gets depends on......

Words: 1829 - Pages: 8


...Medicaid as we know it is a critical source of health coverage for many people especially senior citizens, and people that has a disability. It is vital to those who are in dire need of being in a nursing home and other long term care as well as their families. There has been numerous times where there have been threats to cut Medicaid so severe that it could possibly cripple the program and put all its enrollees at risk. Medicaid provides a huge proportion of the revenue for many health care facilities including Krona’s community hospital. In order for things not to get worse they must be able to protect the pay rate for services that are being provided as well as services that are being covered by the rate. Most healthcare facilities, will more than likely be affected by the cuts if Medicaid. Medicaid is a very important source of revenue for most medical centers including Krona’s community hospital. The impact of Medicaid cuts can’t be overstated. Medicaid cuts affects everyone in some form or another, it affects the patients, providers, families as well as the entire economy. There have been so many changes with Medicaid in the last few years that the payments from Medicaid have affect the ability for medical facilities to survive with such harsh cuts bringing them down. Krona’s facilities has the choice on whether or not they want to continue to provide services for patients but they must know that if doing so they risk not being reimbursed for the services that......

Words: 283 - Pages: 2

The Expansion of Medicaid and Its Impact on Hospitals

...The Expansion of Medicaid and Its Impact on Hospitals As part of the Patient Protection Affordable Care Act 2010 (PPACA), Medicaid was to be expanded to include childless adults whose income was at or below 138 percent of the federal poverty level. Currently, 19 states have not expanded Medicaid coverage. This paper will discuss the financial impact on hospitals in the states that have. Further, differences between how for-profit hospitals versus not-for-profit hospitals are impacted, and the perspectives and responsibilities of the financial management staff will be reviewed. Lastly, rules, standards, and regulations related to how the financial management staff of these hospitals must handle such regulations will be addressed. (GCU) The Patient Protection and Affordable Care Act originally required states to expand their Medicaid programs to provide health care coverage to people earning as much as 138 percent of the federal poverty level regardless of whether or not they have children living at home. However, in 2012, a Supreme Court ruling made Medicaid expansion optional for the individual states (Ellison, 2014). As of July 20, 2015, 30 states including the District of Columbia had chosen to implement expansion. Utah is still debating the issue, while 19 remaining states have decided not to expand Medicaid coverage. According to the Congressional Budget Office, by 2016, the ACA is expected to reduce the number of uninsured by 25 million, with a 12 million increase in......

Words: 1169 - Pages: 5


...Expansion & Diversification Presented by Case Background Carlsberg Incorporated in 1969. Came to Malaysia after two years incorporated through brewing Carlsberg Green Label beer for Malaysian Market. Carlsberg Brewery Malaysia Bhd (Carlsberg) market leading company that hold 50% shares of beer and stout market. Owned by the Carlsberg Group of Denmark. Cont... Carlsberg Malaysia Sdn. Bhd. one of the subsidiary that wholly owned become main marketed locally product. Carlsberg enter into many investment and acquisition through all the years. Competitor in the same industry Guinness Anchor Bhd. Case Background ABC Consulting Sdn Bhd Consist of David as one of the consultant and Robert Stanley as a Head of the company. Specialised in business turnaround. Mr. Stanley suggested that the company to focus more on cash-rich company that want to expand, diversify or venture. David grab the opportunity by looking beer and stout company and found that Carlsberg Company as a target. Cont... By looking through Carlsberg position, David feels that expanding is not worth it and cannot able to sustained their profit. He prepared himself with information before approaching Calrsberg company regarding the diversification activities. Also take and opportunity by selling his idea of manucfacturing sparkle grape juice (halal product) once the Carlsberg company tend to choose to diverse by taking Guinness as an example. ABANG MUHAMAD ZAIM BIN ABANG ALI......

Words: 981 - Pages: 4


...Medicaid And The Problems The Program Faces Research Paper Introduction Medicaid is the largest health insurer in the nation, providing care to more than 50 million Americans with an annual cost around $250 billion. With Medicaid being the largest insurer in the United States, they face many problems and concerns, including limited access, low quality of care, financing and reimbursement concerns, and increased costs. Medicaid Reform is in the near future and with Medicaid’s spiraling costs, mandated managed care ought to be. The Medicaid program, created by the Social Security Amendments Act of 1965, is a partnership between the federal and state governments to provide healthcare to low income and vulnerable populations. The Federal Centers for Medicare and Medicaid Services (CMS) monitors the Medicaid program and establishes broad guidelines for program eligibility, services covered, the delivery of services, and the quality. Each state administers their own program with specific eligibility standards including the type, amount, duration, the scope of services covered, and the payment levels for services provided, (Perlino, 2010). Medicaid operates as an entitlement program making the federal government, under federal law and the budget process, obligated to pay their share of each state’s Medicaid program. The federal government matches the states spending services, varying from 50 to 77 percent depending on the state. Currently the federal government......

Words: 2045 - Pages: 9


...Audrick Willis The Medicaid program was established under title xix of the social security act of 1965 to pay for health care for individuals and families with low incomes. Applying for Medicaid benefits a person must meet minimum federal requirements of the state in which they live, also call or write the local office to request for an application. Factors that determine eligibility for Medicaid are people with low incomes and few resources who receive financial (TANF). People who receive faster care or adoption assistance under title IV-E of the social security act, Children six years of age who meet (TANF) requirements or families who income is below 133 percent of the poverty level. Pregnant women whose family income who is income is also below 133 percent of the poverty level, and infants born to Medicaid eligible pregnant women however, people who are age sixty five and over, legally blind, or totally disabled and who receive supplemental security income(SSI) are also eligible for Medicaid. Medicaid offers two types of plan fee-for-service and managed care plan. Fee-for-service plan allowed patient to choose a provider of their choice, as long as that provider accepts Medicaid. These providers submit the claim to Medicaid and are paid directly by Medicaid. Managed care plans restrict patient to a network of physicians, hospitals, and clinics. Individuals who enrolled in managed care plan must obtain all service and referrals through their primary care provider (PCP)...

Words: 559 - Pages: 3


...Budget Cuts in a Shelby County Clinic: A Case Study Rebecca manages a Shelby County clinic in Memphis, Tennessee. The clinic serves the local Medicaid population. The clinic’s budget was cut by 15%. Rebecca must determine what clinical services can be eliminated or introduced to best address the healthcare needs of the patients. In order to make the best decision for the clinic and the patients, Rebecca will use the Informed Decisions Toolbox (IDT) (Arroyo et al, 2007). Following is a case study of Rebecca’s decision making process. The IDT will be defined and Rebecca will follow the steps to make an informed decision. Her decision to focus the clinic’s efforts on early intervention, preventive medicine, STD/HIV prevention, and case management will be explained. Why the Four A’s tool is determined to be the most effective in making the decision will be addressed (Arroyo et al, 2007). Finally, the use of the toolbox and the affect on the clinic’s accountability, knowledge transfer, and becoming a questioning organization will be studied. The Informed Decisions Toolbox (IDT) The Informed Decisions Toolbox (IDT) is a set of tools that can be useful to healthcare managers when making decisions. The toolbox consists of six steps that can lead to a well-informed decision: Step 1: Framing the question Step 2: Finding sources of information Step 3: Assessing the accuracy of the evidence Step 4: Assessing the applicability of the evidence Step 5: Assessing the......

Words: 1835 - Pages: 8

Medicaid and Stakeholders

...Medicaid 1 Medicaid and Stakeholders On July 30th 1965 the Medicaid program was created to address the poor and elderly uninsured population in the United State. This voluntary program is administered on a State level but regulated on a Federal level. The Center for Medicare and Medicaid Services (CMS) is the organization that over sees the delivery, quality, funding, and eligibility of the program. Each individual State can choose how to operate the Medicaid itself. The program is design to help people with low income, children, parent of those children, pregnant women, disabled and elderly people in need of a nursing facility. Medicaid is a complex system because it is not a single program and runs differently in each State. It is a very costly system because its serves the poorer population and the long term patients. Currently Medicaid is experiencing changes on all levels. The rise in unemployment has caused an increase in applicants who qualify thus driving up the costs associated. With the passage of the Patient Protection and Affordability Care Act (ACA) the general consensus is that the Medicaid has some current issues to address before more people fall under their umbrella of services. Currently there are more than 59 million people enrolled the Medicaid system for health care. The system is expected to add nearly 16 million more people by 2019. With State governments facing a budget crisis many are looking to cut the Medicaid program. The Federal......

Words: 1078 - Pages: 5