...Expansion of Medicaid Name School Abstract 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...
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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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...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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...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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...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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...Budgetary Analysis Angel Lowe HCS/550 March 2, 2015 John Dean Budgetary Analysis Medicaid counts as one of the largest sources of public health insurance in the United States, and also in the whole world. It provides essential medical cover to vulnerable population within the United States. This population includes elderly individuals, expectant mothers, children, low income families and individuals with different physical disabilities and the disadvantaged in the American society. In 1965 President Johnson signed into law under the Social Security Act to improve the health care of the elderly with Medicare. Medicaid would provide improved health care for the poor, unwed mothers, children, and the disabled. The program involves a joint initiative between the states government and the federal government hence the two governments jointly fund the program and ensuring its success through putting up laws to guide its implementation. President Obama’s legacy will be protecting the health of the individual American. The health care policy rules, regulations, and legislations are the consequence of the policy procedure which involves legislators, all the decision-making branch leaders, and public also. The budget for Illinois starts when the Governor submits a bill each January to the House of Representatives. After the bill has been submitted by the Governor then the house is responsible for ways and means review then they budget and develop their own recommendations...
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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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...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 his/her...
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...Health Care Spending in the United States Lisa Patti HCS/440 April 23, 2012 Caryn Callahan Introduction Heath care in the United States is costly and confusing. Many do not follow the facts, policies or cost the government has controlled in health care. This leads to obtaining the incorrect insurance that causes high out of pocket expenses to choosing no health insurance at all. In today’s society many cannot afford health insurance, in 2010 49.9 million people in the United States were without health insurance (Overview of the Uninsured in the United States: A Summary of the 2011 Current Population Survey, 2011). The issues that will be discussed are the level of current nation health care expenditures, whether spending is too much or not enough, where the nation should add or not, and why, and how the public’s health care needs are paid for and financed by various payers. The current level of national healthcare expenditures U.S. health care costs have risen rapidly in the past few years, imposing increased stress on families, businesses, and public budgets. Health spending is increasing more rapidly than the economy and workers' earnings. In recent years, insurance administrative overhead has been rising faster than other components of health spending, while pharmaceutical spending has increased more rapidly than spending on other health care services (The Common Wealth Fund, 2007). The national health care expenditure is a total amount spent in the United States...
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...Are Doctors accepting Medicaid Patients as Obama has Signed the Affordable Care Act Rider University 2083 Lawrenceville NJ 08648 5/2/2013 Rider University 2083 Lawrenceville NJ 08648 5/2/2013 Arunabh Sinha Arunabh Sinha Abstract On March 23, 2010 President Obama signed into law the Patient Protection and Affordable Care Act (PPACA), also known as Obama Care. As a direct result of this there are going to be more people on Medicaid and also more “baby-boomers” are going to be turning sixty-five thus qualifying for Medicare. Although fewer doctors are accepting government insured patients! This paper will research the number of doctors accepting governmentally insured patients and also if there is a shortage in the number of providers as the PPACA goes into effect. With data provided from the American Medical Association (AMA), Center for Disease Control (CDC), and other academic journals an evaluation is going to be made of if there is enough doctors to meet the demand of newly insured patients in the US. Issues of access and quality of care will also be addressed in this paper. Are Doctors accepting Government Insured Patients as Obama has Signed the Affordable Care Act On March 23, 2010 President Obama signed into law the Patient Protection and Affordable Care Act (PPACA), also known as Obama Care. As a direct result of this there are going to be more people on Medicaid and also more “baby-boomers” are going to be...
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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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...The Affordable Care Act at 5 Years Mary Beth Hamel, M.D., M.P.H., Editor Authored by David Blumenthal, M.D., M.P.P, Melinda Abrams, M.S., and Rachel Nuzum, M.P.H. Published 2015, The New England Journal of Medicine Laurie Bailey Reinhardt University Healthcare Law, Regulations, and Ethics Spring 2016 Journal Review Abstract The Affordable Care Act (ACA) has been one of the most controversial pieces of social legislation enacted in recent history. We know the law has had a considerable impact on the availability of health insurance. In addition to its expansion and reform of health insurance coverage, the Affordable Care Act (ACA) contains numerous provisions intended to resolve underlying problems in containing health care costs and improving the quality of care for Americans. These provisions focus on three broad areas: testing new delivery models and spreading successful ones, encouraging the shift toward payment based on the value of care provided, and ensuring protection against illness and the ability to receive care. While it is still far too early to offer any kind of definitive assessment of the law’s reforms since some of the provisions did not take effect until much later after its passage, it is clear that the ACA has changed healthcare in the U.S. and is promoting providers to improve the value obtained for our health care dollars. In 2010, Congress passed and President Obama signed into law the Patient Protection and Affordable...
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...Policy Process: The Affordable Care Act Dinah Riveron HCS/455 May 18, 2015 John Cutspec Policy Process: The Affordable Care Act The Patient Protection and Affordable Care Act signed by President Obama on March 23, 2010 as the means to enforce Health Insurance reform. Its main object is to make Health Insurance and Preventive care accessible and affordable to the American population. The Affordable Care Act The ACA major components include: Medicaid expansion, allowing states the opportunity to expand their existing Medicaid programs to include, (OPA, 1015) “individuals under 65 years of age with incomes up to 133% of the federal poverty level… (as well as) certain low-income adults without children” (Medicaid Expansion). Health Insurance Marketplace (HIM), available for access to individuals and small businesses enabling them to compare a variety of plans on the basis of price, quality and benefits and to choose the most affordable option according to their needs. The proposed three models are State Operated, State and Government Operated, and Federal Government Operated, for States that choose not to establish a program. Under the ACA, health services provided by all Insurance companies (participating or not on the HIM) are required to offer individuals and small businesses, affordable health Insurance plans that allow access to ten services identified as Essential Health Benefits (EHB). EHB services include, Ambulatory and Emergency services, Hospitalization...
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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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...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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