...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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...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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...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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...Assignment 2 Financing and Restructuring Health Care Dr. David Tataw HSA 500 Health Services Organization January 28, 2012 Abstract: This paper analyses the Financing and Structuring Health Care by analyzing four important notions. Firstly it Identifies and describe the three main types of health insurances in the U.S. Secondly it explains the three methods for categorizing health insurance in the U.S. This is followed by a synthesis of the pros and cons of managed health care for the health care provider, insurer, and patient. Finally the papers describe the impact of managed care on both the Medicare and Medicaid programs. Identify and describe the three main types of health insurances in the U.S. Rodts (2010) talks about the new Healthcare system in US and the challenges it brings for healthcare providers but there is always challenge when one has to select the certain type of health cover for himself. It is therefore important to understand main types of health insurance in the US. While Hall (2010) outlined the three different types of reinsurances brought about by the health reform, Health Insurance Info (2010) notes that are a number of different types of health insurance coverage designed to meet the needs and budget of a variety of individuals. In essence, health insurance is a risk management tool that ensures you and your family has access to the healthcare you need, when you need it without causing a tremendous financial burden. The cost of health insurance...
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...and Grady Hospital Atlanta Metropolitan Market The Atlanta Metropolitan market for healthcare services is dominated by nonprofit healthcare systems, including the academic medical system Emory Healthcare. Emory became the largest healthcare system in the market after its acquisition of St. Joseph’s Hospital of Atlanta. It is expected that the consolidation of healthcare systems will continue as healthcare reform and market forces make it difficult for smaller hospitals to remain independent. The 28 county Atlanta market has 43 acute-care hospitals with an estimated 459,909 inpatient discharges annually and 9,796 total acute-care beds. The average daily occupancy rate is 64 percent, and the average length of stay is 4.9 days (A Decision Resources Group Company, 2012). Grady as a Public Hospital Grady Health System operates Grady Memorial Hospital which is Atlanta’s public safety net hospital. Grady currently serves 7 % of the Atlanta market and Grady’s market share is 22 % Medicaid and 22 % self pay or uninsured. After the implementation of the ACA, one would assume that Grady will continue to serve 22% of Medicaid patients and 22% of the uninsured. Grady will continue to be Atlanta’s safety net hospital after the full implementation of the ACA (A Decision Resources Group Company, 2012). Grady has the only Level I Trauma center in the region and the state’s only poison center. Grady Memorial Hospital offers extensive medical care that other area hospitals do not offer;...
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...The Paradox in the Affordable Care Act Submitted By: Vodney Wynn vewynn@aol.com October 12, 2014 PA582_CourseProject Table of Contents Introduction…………………………………………………………………………………………………………………3 The History of Healthcare Reform……………………………………………………………………………..…4 The Problem with the ACA……………………………………………………………………………………………6 The Current Policy………………………………………………………………………………………………………..8 Policy Alternatives………………………………………………………………………………………………………10 Evaluation Criteria………………………………………………………………………………………………………10 Policy Recommendation……………………………………………………………………………………………..12 Conclusion…………………………………………………………………………………………………………………..13 References………………………………………………………………………………………………………………….14 Introduction Recent health care reform legislation, The Patient Protection and Affordable Care Act and Education Reconciliation Act, which is now being referred to simply as the Affordable Care Act (ACA), was signed into law by President Obama on March 23, 2010. Since the 20th century, several United States presidents have faced challenges in passing national health reform into law. Before the ACA was enacted, national health reform proposals under different governments in the United States faced strong opposition from various stakeholders and multiple interest groups. Therefore, the enactment of the ACA is revolutionary healthcare reform in the history of the United States. Healthcare insurance is a program that assists in paying medical expenses through privately purchased insurance...
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...indigent population of Florida. They are as follows. Government services, including Medicaid, the State Children’s Health Insurance Program (SCHIP) and Accessing Community Care through Eastside Social Services (ACCESS). These programs enable eligible low-income individuals and their families to seek medical assistance reducing uncompensated care and hospital costs. The primary source of funding for uncompensated care is government dollars. The government collects taxes to fund various public services. American taxpayers have every right and should be concern about how the money is being spent. Controlling tax expenditures poses a major concern especially when considering reducing deficit as well as reducing taxes for Americans. The federal government is by far the largest funder of uncompensated care. In 2013, the federal government provided $32.8 billion (61.5 percent) to help providers cover costs associated with caring for the uninsured. State and localities are the second largest, providing another $19.8 billion; the private sector is estimated to contribute $0.7 billion (Caswell, Coughlin, Holahan, & McGrath, 2014). Medicare, Medicaid, SCHIP, and Affordable Care Act marketplace subsidies together accounted for 24 percent of the federal budget in 2014, or $836 billion. Nearly two-thirds of this amount, or $511 billion, went to Medicare. The remainder of this category funds Medicaid and CHIP, which typically on a monthly basis provide health care or long-term care to...
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...National Health Reform - Decreased Cost in Medicare and Medicaid: How Does it Impacts Nursing Home Care in New York State by Vina Aileen Bonner HCA 621 Utica College Fixing medical care and health insurance in the United States has been a public policy concern for about a century. Presidents such as Theodore Roosevelt, Harry S. Truman, John F. Kennedy, Richard Nixon, Jimmy Carter and Bill Clinton focused on the National Health Reform, but only President Barack Obama achieved the health care reform. Health care costs are increasing while the access to health care is declining. The occupationally based health insurance system is greatly stressed. Medicare and Medicaid are consuming more of the federal budget. According to the White House’s budget for U.S. Department of Health and Human Services (HHS), President Obama’s proposal would save nearly $360 billion in Medicare and Medicaid over the next 10 years: $56 billion would come through Medicaid reforms. Medicare is a federal health insurance program providing health care benefits to all Americans age 65 and over. Medicare is a significant part of the reason the national debt is soaring out of control. It is an open-ended program for provided for millions of senior citizens and people with disabilities. Medicare is growing faster than Social Security and more expensive in the next 25 years. Nationally, health care experts believe that as much as third of all health care spending – about $800 billion in...
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...insurance, beneficiaries most often led a lower quality of life. As health care services have outrageous prices, many of them almost never visit a physician/hospital unless absolutely necessary. Though most people don’t realize, one requires medical care at some point in their life. Therefore when they actually receive care (without insurance), it often leads to medical debts and opportunity costs of housing, healthy eating, social life etc. Medical debt contribute to 50% of bankruptcies in our. The government is affected greatly with the uninsured population. Many individuals remain uninsured due to the high costs. Some, even though they have insurance, hesitate to receive medical care due to costly deductibles and co pays. Medicare and Medicaid receive a large number of these individuals who delay care to the very last minute and requires costly services. The financial burden on the government increases with increasing amount of population without health care insurance. Additionally, the health outcomes in our country are worse compared to other industrialized countries because of the lack of continuum of care and high costs in the country. Hospitals, especially non-profit hospitals often have marginal operating profits. Therefore, the increment of the uninsured population even by a small percentage has a huge impact and determines their yearly profits and losses. Though the ACA...
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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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...Because of the huge expansion that has occurred it has driven the costs over the projected amount and Medicaid has already passed its healthcare costs expense obligations. Also, the article researched that there is an estimated 3 million uninsured illegal immigrants who would qualify for Medicaid. The national healthcare Medicaid budget expansion for the next four year was written and 3.1 million immigrants would costs taxpayers $48.6 billion dollars. This amount in its own would substantially have a huge blow on our healthcare economy. (Edwards Jr,...
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...Obama to ensure all Americans have health insurance coverage. This law became a federal mandate in 2014. This legislation has multiple goals: requires all United States citizens to have health insurance, insures all persons at the national poverty margin with Medicaid coverage, offers adequate health coverage to employees through the employer, and mandates private insurance companies reduce the amount of exclusions for pre-existing conditions to maintain federal compliance. Prior to the enactment of the ACA, there were approximately more than thirty million Americans without health insurance (Sparer, 2011). This legislation allows the federal government to have more control over private health insurance sectors and strives to ensure the health care of all Americans at the national level . The Impact of the Affordable Care Act on North Carolina’s Uninsured Population As of 2011, if you were a North Carolina resident, poor, homeless, unemployed and without child, you were eligible for Medicaid (Milestead, 2013 ). The ACA was implemented to help these citizens. As of June 2012, the Supreme Court ruled the ACA’s implementation could be determined by each state. NC is one the states that refused Medicaid expansion funding and refused to implement many of the Affordable Care Act’s policies. As of 2013, this state had approximately, three-hundred nineteen thousand people below the national poverty level. Unfortunately, this still leaves many of their residents without health...
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...Health Care Law and Regulations University of Phoenix Louise Underhahl HCS 545 Health Care Law and Ethics 2012 Health Care Law and Regulations One of the areas that are currently affecting the Health Care industry is Regulatory agencies. There is much dissatisfaction over the current state of healthcare in the U.S. Within all of our organizations, regulatory agency surveys are conducted to better the organizations as well as its employees. The purpose of the regulatory surveys is to focus on the areas that need improvement as well as promoting better health care access to the people in the community. Regulatory agencies serve as authority as well as enforcement to regulate laws from the government. Some examples of regulatory agencies are Food and Drug Administration (FDA), Agency for Healthcare Research and Quality (AHRQ), and Occupational Safety Health Administration (OSHA). There are many examples of laws and regulations that are currently being faced in health care. Analysis of health care laws and regulations help one understand their influences on the provider. There are many ways that laws and regulations affect our lives and community. The FDA is responsible for the oversight of drugs, medical devices, vaccines, blood products and biologics, establishing rules for testing, clinical trials and approval of new products. The AHRQ is a federal agency under Health & Human Services working to improve the quality, effectiveness and safety of health care...
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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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...Running head: THE IMPACT OF THE AFFORDABLE CARE ACT 1 THE IMPACT OF THE AFFORDABLE CARE ACT 2 The Impact of the Affordable Care Act The Affordable Care Act was signed into law in March 2010 by President Obama and has reformed the way health care is handled in the United States. The Affordable Care Act prohibits insurers from denying coverage for preexisting health conditions making it a landmark movement by trying to improve and control costs in health care. A significant impact has been made on the provision of health coverage to Americans, and is the most far-reaching law affecting managed care and insurance since the enactment of Medicaid and Medicare (Kongstvedt, 2013). By ensuring that all Americans have access to health care and are covered under some kind of policy, the Affordable Care Act is expected to give 30 million more Americans health insurance putting an increased demand on an already taxed workforce. According to Anderson (2014) the ACA breaks the promises of access and quality of care for all Americans by escalating the shortage and increasing the burden and stress on an already fragile system. Although there are many kinks to work out, health care reform is not only necessary, but it must happen in order to keep moving forward. Before reform our health care system was truly in crisis. The Impact of the ACA on Current Practices in Health Insurance The ACA has changed a lot in health insurance...
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