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 and families. According to Medicaid.gov, Georgia is not expanding Medicaid coverage to low-income adults. However, there are many other states that decided to expand their Medicaid coverage. For a pregnant woman in Georgia to receive Medicaid, the income level must be no more than 2,844. States have the option to extend Medicaid coverage to pregnant woman up to or over 185% and majority of states have decided to so. States have the option to provide pregnant women with full Medicaid coverage. Medicaid has played a major role in child and maternal health. Medicaid finances 40% of all births in the United States. For pregnant women who receive Medicaid, it covers prenatal care through pregnancy, labor, and delivery, and also for 60 days postpartum as well as other pregnancy related care. Eligibility is determined for pregnant women, she will remain eligible for Medicaid through the end of the calendar month in which the 60th day after the end of the pregnancy falls, even if there is a change in family income. Infants born to pregnant women who are receiving Medicaid for the date of delivery are automatically eligible for Medicaid. ObamaCare Medicaid Expansion is one of the biggest milestones in health care reform. ObamaCare's Medicaid expansion expands Medicaid to our nations poorest in order cover nearly half of uninsured Americans. The law previously required states to cover their poorest or lose federal funding to Medicaid (federal funding covers 90-100% of state costs) until the supreme court ruling on ObamaCare. States can now opt-out of Medicaid Expansion leaving millions of poor working families without coverage. Many of the State's that reject Medicaid Expansion are those who need it the most. States opting out of the expansion of Medicaid under ObamaCare is projected to drive up insurance costs drastically. As of 2013, every State had different eligibility requirements based on income, age, gender, dependents, and other specific requirements. Since every State covers those who have no income, expansion would almost exclusively be covering the working poor and their families. Poor working families are the most likely to not have insurance do to affordability, Medicaid expansion helps "covers the gap" between current Medicaid eligibility and families being able to afford private health insurance using marketplace subsidies. About half of the uninsured in America would be covered by Medicaid Expansion if all states opt-in. Millions of Americans will be able to get care before they are forced to use costly last minute emergency services in state's that support expansion.
The uninsured currently cost hospitals billions in unpaid hospitals bills, these costs are indirectly passed onto the average taxpayer with insurance. Unpaid hospital bills to hospitals are one of the main causes of rising premium costs. The Federal Government pays 100% of expansion costs for the first three years and 90% thereafter until 2022. Many states have shown that Expanding Medicaid actually raises money for the State. Cost is the most cited reason for not expanding Medicaid. While current Medicaid programs do costs state taxpayers a lot of money, that spending is balanced by unpaid hospital bills and the affect those bills have on the rising costs of premiums. Every State who opt-ed out of expansion has a Republican governor that is against the program. States had until January 2014 to decide if they would expand Medicaid. Many states are not moving forward with the program at this time, however they can still decide to expand Medicaid later. The Affordable Care Act also includes new taxes. Most new taxes are on high-earners, large businesses, and the healthcare industry. However, there are some tax related provisions every American should be aware of: Tax Credits to subsidize costs for low-to-middle income Americans and small businesses starting 2014, an Employer Mandate for large employers to provide health insurance to full-time employees by 2015, an Individual Mandate for individuals and families obtain health insurance by 2014, and lastly new limits to medical deductions. Over 100 million Americans have already benefited from the new health care law. This includes more than 105 million people who accessed critical preventive services for free that had previously been subject to out-of-pocket costs, billions of dollars saved for seniors from the gradual closing of the Medicare Part D "Donut Hole", billions saved from new accountability measures for insurance companies, and much more. A "short coverage gap" exemption means that you can go up to three months in a row in 2014 without insurance and still avoid the per-month fee on your 2014 federal income taxes for not having insurance. This covers not having insurance January 2014 to March 2014. There is another coverage gap exemption that applies to those who purchase marketplace insurance between March 15th and March 31st, 2014. This covers you for April 2014 as your coverage won't start until May 1st, 2014. Insurance purchased by the 15th of each month starts on the 1st. The Health Care Reform under the Obama Administration is called The Affordable Care Act. This act has been passed by congress and sign by President Obama in March 2010. This Act provides Americans with better health security, lower health care cost, more choices, and enhances the quality of care for all Americans. We can expect to see a lot more offered from this Act in 2014. Private insurance outside of the marketplace, Medicaid and CHIP don't have open enrollment periods. The health insurance marketplaces, Medicare and employer based insurance all have open enrollment periods.
Even if you miss open enrollment for ObamaCare you can still buy a private health insurance plan outside of the marketplace to avoid the per month fee for not having insurance. Please note that you won't be able to use subsidies outside of the marketplace and will still owe the fee for each month you go without insurance or an exemption. If you miss open enrollment you can still sign up for Medicaid and CHIP, but you won't be able to use the marketplace to do so. Medicaid and CHIP eligibility differs in each state due to the fact that many state did not expand Medicaid The Health Care Reform is the best thing that has happened for America. Especially for the majority of Americans who find this reform beneficial. According to Warren Richney, the Federal Government recovered nearly $4.1 billion in 2011, nationwide crackdown against health-care fraud. The Health Care Reform has allowed the Obama Administration to capture all the health care scams that has been ripping Americans off with increased restitution and fines. There are many reasons why I find this Reform good for America. This new law has banned lifetime limits placed on health insurance. Before the Reform, patients who had cancer, suffering from serious or chronic diseases were often forced to limit or go without treatment because of an insurance provider lifetime limit on their coverage. Now, insurance companies are prohibited from placing a lifetime limit on the amount of coverage. Families can now live with the security of knowing that their coverage will be there when they need it most.
Another good thing about this Health Care Reform is that it banned insurance companies from canceling coverage when you need it most just from making a simple mistake on your application. According to the Healthcare-overview, approximately 10,700 people have their coverage dropped each year because they got sick or made an unconditional mistake on their application. This Reform also allows for young adults to remain on their parent’s plan until their 26th birthday, unless they are offered coverage a work. Because of this new law, up to 1.8 million uninsured young adults could benefits through this new law.
Before the Reform, tens of thousands of families have been denied insurance each year for their children because of an illness or pre-existing condition. New rules will be implemented from denying coverage to children under the age of 19 due to a pre-existing condition. Insurance companies’ ability to place annual limits on care will be restricted. By the year of 2013, up to 3,500 people will gain coverage as a result of the ban on restricted annual limits that insurers impose on nearly 18 million people today.

References

"How to Explain Obamacare to Your Kids." About.com US Economy. N.p., n.d. Web. 16 Apr. 2014.
"ObamaCare Facts: Facts on the Affordable Care Act." ObamaCare Facts: Facts on the Affordable Care Act. N.p., n.d. Web. 15 Apr. 201.References
"ObamaCare Medicaid Expansion." ObamaCare Medicaid Expansion. N.p., n.d. Web. 16 Apr. 2014