...Executive Summary Medicaid eligibility expansion under the implementation of PPACA is to include individuals and families with incomes up to 138% of the federal poverty level, including adults without disabilities and without dependent children. According to the supreme-court ruling, states have an option to opt out of Medicaid expansion. Washington State is one of those states that have decided to implement Medicaid expansion. Community health centers (CHC) play a vital role in providing care to uninsured and low-income people even if the patients regardless of their ability to pay. CHC are also known as Federally Qualified Health Center (FQHC). One such community health center in Spokane is CHAS. The purpose of this analysis is to assist...
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...I am for the expansion of Medicaid under the federal Affordable Care Act. Government should strive to assist its citizens who seek help and cannot escape poverty however; there are of course grounds as to why all states do not full support each and every citizen. This paper is supporting the expansion of Medicaid, providing counter arguments against Medicaid expansion, and stating why it is this paper is in support of Medicaid expansion. Medicaid expansion could assist “About 406,000 Texans with mental illness and substance abuse disorders…” this doesn’t even include those who just don’t have the required income to qualify (Chang, Medicaid). I am for the expansion of Medicaid. Medicaid aids those in need, those who struggle to maintain themselves,...
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...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 Medicaid...
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...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 to...
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...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 choice;...
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...granted. As someone who is insured by Medicaid, I am very grateful for it. Realizing that there is a coverage gap is something that needs to be addressed. I couldn't imagine having to pay for all of my medication out of pocket. No one chooses to have an illness that requires medicine, and I believe everyone has the right to have access to affordable health care. I will argue that Virginia expanding Medicaid would make a positive impact on the state What does expanding Medicaid mean? This expansion could impact your neighbors, friends, classmates, and so many more. There is an article from KFF that makes a wonderful explanation. The ACA Medicaid expansion was designed to address the high uninsured rates among low-income adults, providing a coverage option for people with limited access to employer coverage and limited income to purchase coverage on their own. In...
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...Isaac Rogers 1 March, 2015 Prof. Watson PHSC 2 ACA Section 2551 Disproportionate Share Hospital Payments The Federal Government provides supplemental funding to “disproportionate share” hospitals (DSH) which are hospitals that serve a large number of Medicaid, low-income, and uninsured patients. Under federal law, state Medicaid programs must take into account the situation of these hospitals and provide a supplemental payment to the normal reimbursement the hospital would receive under Medicaid for inpatient services. These supplemental payments, known as DSH payments, are determined by a hospital’s disproportionate patient percentage, which is the sum the Medicaid fraction and the Medicare and Supplemental Security Income fraction expressed as a percentage. In many cases, disproportionate share hospitals which are often times called “safety net” hospitals rely on this Federal compensation for financial stability. Which hospitals receive DSH compensation, and the amount of compensation is determined by each state. The affect of the passage of the Affordable Care Act on the uninsured population is significant. The Congressional Budget Office estimates that an expansion of public health care programs and the availability of new health insurance coverage options under the ACA will reduce the number of uninsured by 32 million. Keeping such expectations in mind, the ACA proposes policy for reducing DSH payments to reflect lower uncompensated care costs relative to increases...
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...1. Point-Counterpoint State Medicaid Policy and Health Reform Harold A. Pollack University of Chicago Authors: Pollack, Harold A.1 Source: Journal of Health Politics, Policy & Law; Feb2013, Vol. 38 Issue 1, p161-163, 3p The article discusses the positive and negative implications of the new ruling that the federal government could not require states that receive federal funds under the Medicaid program to participate in the Patient Protection and Affordable Care Act's (PPACA's) Medicaid expansion. Several shortcomings like limited provider payment and associated patient access barriers have been observed in Medicaid that make its adoption not a good idea. However, families below the poverty line can benefit. In July 2012, the Supreme Court upheld the constitutionality of the Patient Protection and Affordable Care Act (PPACA). The Court thus ended one phase in the political and legal battle over health reform. Yet in doing so, it opened a new front. In a notable departure from post–New Deal commerce clause jurisprudence, the Court ruled that the federal government could not require states that receive federal funds under the Medicaid program to participate in the PPACA’s Medicaid expansion. In effect, the Court made states’ participation in the PPACA’s Medicaid expansion voluntary — a possibility that neither the act’s supporters nor its opponents seriously entertained during the long legislative battle of 2009 and 2010. The full implications of these...
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...long-term, the Medicaid expansion will save both state and federal government’s money while extending healthcare coverage to millions of lower-income Americans. Opponents say it is just another example of government overreach and that it is up to the states to determine whether they can afford such an expansion.” But my question to you is do you actually believe this? Because I don’t. I have come across the best argumental FACTS to help you better understand the reason Rick Perry does not want to expand Medicaid. Researchers Laura Dague, Thomas DeLeire, and Lindsay Leininger argue in a National Bureau of Economic Research working paper that… “Noted in February that Obamacare’s Medicaid expansion would reduce incentives to work and have a modest effect on the overall supply of labor. While there is a debate in the academic literature about the effects of the Medicaid expansion on labor supply, that debate has tended to focus on parents who enroll in Medicaid, rather than adults without kids. Dague and her colleagues conclude that if the Medicaid expansion enrolls about 21 million additional adults, anywhere from 511,000 to 2.2 million fewer people will be employed. Furthermore, they argue that the Medicaid expansion will knock almost a full point off of today’s labor force participation rate -- or share of the civilian population that is working -- a measure of economic health that is already at its lowest point since 1977.” That’s why people for Medicaid expansion need to take a...
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...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 individuals...
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...Another aspect that should be repealed is Medicaid expansion. Medicaid promises individuals health coverage, however it denies them access to quality doctors. This happens too often, with about 40 percent of primary care doctors not accepting Medicaid patients, because the reimbursement is too low. The result is that patients on Medicaid have worse outcomes after major surgeries, high infant mortality rates, and go to the emergency room more often. (F) Even with these access issues, Medicaid spending is constantly increasing. The total federal and state spending on Medicaid exceeded $400 billion dollars in 2010. The Medicaid program currently is struggling to provide care to its core obligations (low income children, disabled, pregnant women,...
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... There are numerous debates over the new Affordable Care Act; more commonly known as Obamacare. The expansion of Medicaid is a debate within the legislation that should have more attention brought to it. First off, the expansion is an increase in those who are eligible for Medicaid and is optional for the states. On the surface it seems like a wonderful provision within the ACA and it is important to note that from a financial standpoint it is in the states’ best interest to take part in this expansion because the federal government is going to cover all expansion costs for the first 5 years and subsequently decrease it afterwards—but only by a nominal margin. However, a problem comes with this expansion when you take a closer look; a newly saturated beneficiary pool with the same or decreasing number of primary care physicians that will accept them. This is going to spell disaster for all Medicaid beneficiaries and the states that partake in this expansion. This expansion should be cut from Obamacare all together and have the funds reallocated in two ways: 1. increase the number of primary care physicians by subsidizing their degrees (i.e. similar to Medicare) and 2. create federal mandated minimums that states must pay doctors who accept Medicaid. Medicaid currently accounts for an average of 24% of state budgetary spending. This is partially due in part to Medicaid beneficiaries going to the emergency room for minor health issues that could better be served by a primary...
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...income between 100% and 199% of the FPL (“South Dakota Medicaid,” 2014). I believe that a large number of the persons listed in this statistic are college students. For the Fall, 2013 semester there were 47,590 students enrolled in the 31 colleges and universities in South Dakota (Current Term Enrollment, 2013). I encourage you to expand the Medicaid program in South Dakota to, at the bare minimum, allow for coverage to our state’s young people who are pursuing higher education. In this report I will be reviewing the history of Social Service programs and the amendments made to them in the United States and South Dakota. The parties involved include the Federal government, the South Dakota Legislature and the citizens of South Dakota. The report will be a chronological history. Origins of Social Welfare for Medical Care The American Association of Labor Legislation (AALL) was formed in 1906 and their committee on social welfare drafted a bill in 1915 that outlined coverage to the working and low income classes. It included coverage for hospital and doctor care as well as maternity coverage and sick pay. The issue was highly debated for many years but eventually it was abandoned by the end of World War I (Palmer, 1999). Modern Community Health Program coverage has it’s beginnings in the Social Security Bill passed in 1935. That bill established the Medicare and Medicaid programs that are still in effect today. Medicaid was set up as a way to provide coverage for the disabled...
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...Texas’ Decision Should Texas have Medicaid or not? Texas has decided to refuse expansion of the Medicaid program under the Federal Affordable Texas Law. Now, the huge question remains, “Has Texas made the right decisions or did Texas move to fasting the decision making? “Medicaid helps the lower class families with the cost of Medicaid bills, but Medicaid is fun by states where coverage may vary. In an article “Texas”, Texas had 83.7% of people who participated in Medicaid in the year of 2015. There is Texas who support having Medicaid and people who is against Medicaid. I believe Texas should have expanded Medicaid because not everyone is fortune to pay out of pocket for medical emergency. Texas should have expanded Medicaid throughout the...
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...Elaine Bobo Budgetary Analysis The Medicaid program is one of the largest sources of health insurance in this country in addition to employer-based health insurance and Medicare. Medicaid delivers crucial medical related services to the most at risk populations in society. The importance of Medicaid's part in providing health insurance cannot be exaggerated; “the Medicaid program covers millions of low-income women, children, elderly people and individuals with disabilities” (U.S Department of Health and Human Services, 2000). Funding for Medicaid is limited through various federal policies, leaving much of the program’s budget burdened on the individual states to make necessary spending cuts in order to provide the funds needed for the demand of the program. Budgetary decisions need to be thoroughly reviewed before any immediate action is taken as these decisions can create a domino effect on other programs and their participants as sections of this paper will describe. Medicaid Overview Medicaid is a cooperative federal and state program with a common goal to provide a vital service for the general public. “Medicaid is the largest source of federal revenue for states. Medicaid funds support health care providers, jobs and state economies overall” (Kaiser Family Foundation, 2013). Every state institutes its own eligibility criteria, benefits platform, payment rates and program organization under the broad federal recommendations. Medicaid provides three types of vital health...
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