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The Pros And Cons Of Medicaid Reform

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Medicaid is a Federal-State partnership wherein the federal government absorbs the bulk of the expenditure. States are given the flexibility to manage their Medicaid programs as long as minimum federal requirements are met. This arrangement allows states to provide coverage based on their specific structure and needs. 28 States and the District of Columbia signed up for the Medicaid expansions under the affordable care act (David et.al). The states that opted out of the expansions have the most number or uninsured and poor residents. The government of some opt out states are looking at alternative options to provide care for their large uninsured populations but this only leads to disparities in the health care options available to their denizens versus the other states (Omolola et.al). One proposal repeatedly made by the current administration is to limit the federal contribution by switching from the current percentage model to a model of block grants or per-capita caps. Under the block grants model, states would be given a fixed amount of Medicaid funding which they would need to manage. Under the per-capita model, Medicaid recipients will be subject to a reimbursement cap. …show more content…

However, this claim is misleading; states already have a great amount of flexibility in managing their Medicaid programs. In addition, states have used Medicaid to fund innovation through programs such as home-community based care. Such programs have allowed states such as Oregon to reduce the burden on hospitals and emergency care centers. Studies have shown that such programs have reduced costs and improved the health of patients in the long run. Programs focused on preventive care reduce usage of emergency and urgent care. In addition, Medicaid is also used by certain states like Massachusetts to provide care for opioid abuse patients and

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In the United States particularly in rural areas, community health centers serve as safety net hospitals providing healthcare mostly to Medicaid and the most vulnerable patients. Safety net institutions are required by law to provide care to all patients regardless of ability to pay. Research show that the states that expanded Medicaid under ACA saw significant reduction in uncompensated care and improved financial status of safety net institutions With people losing coverage the rate of uncompensated care will be on the rise which will adversely affect the safety net institutions and jeopardize their continued existence. This new policy has been criticized as unnecessary and would be counterproductive and add to program costs in the long run. There will be increase in emergency Department (ED) because uninsured people are known to resort to the ED as their source of primary health care.

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One of the author’s reasoning for how taking away ACA would affect Medicaid is back in 2016 legislation tried to step away from it, but former President Barack Obama repealed it because could eventually affect the lives of millions of people. The authors also cover how ACA changed Medicaid for the better, for example creating a program for just children’s coverage, inventing a new method to determine eligibility, and even creating new benefit options for families and small businesses. The author describes how the new Presidential administration can repeal or alter Medicaid through Section 1115. The authors main argument is that by repealing ACA would eliminate the Medicaid system which in turn will allow millions of people to be

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Because the feds are reducing their overall contribution to Medicaid across the country, the Oregon Legislature is currently considering increasing the hospital provider tax to help make up the shortfall. Davidson's organization has reluctantly agreed to the increase. As lawmakers grapple with a $1.4 billion budget deficit, much of which is Medicaid-related, they are examining every expenditure, including the hospital association's contract with the state. That contract is on the chopping block, and as part of a current Medicaid funding bill in Salem, Oregon Health and Science University is pulling out of the agreement under which it pays the association 1 percent of the provider tax.

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1130 Words | 5 Pages

State-run healthcare can control the cost of insurance by controlling premium rates. According to Louis Norris, 7 of the 13 states with the lowest premiums are state-run exchanges. This is quite a feat since “only 17 of 51 exchanges are state-run, so state-run exchanges are over-represented among the exchanges with the lowest average benchmark premiums.” (Norris, Para. 8).

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595 Words | 3 Pages

Through the Medicaid expansion and change in insured demographics, cost shift, a change in consumer coverage from private health insurance to Medicaid, a lower reimbursement rate, occurs. This results in health care providers receiving a lower average rate of reimbursement per patient. In addition to reduced

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869 Words | 4 Pages

Today, President Trump, like President Reagan, is interested in transferring government spending on Medicaid and giving block grants to the states to control their own Medicaid programs. Many people, even some Republicans, are worried that the states, without much government intervention will cut people from the services they are receiving currently. The politicians who are in disagreement with this proposal strongly favor a more centralized government and cling tight to the original meaning of

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859 Words | 4 Pages

This can include tangible and nontangible treatment for a variety of diseases ranging from mental to physical. In addition to treatment, insurance companies can no longer deny anyone coverage for pre-existing conditions permitting no discrimination to be passed while seeking coverage. Lastly, they cannot drop them or raise premiums if the insured party becomes ill. Failure to provide these crucial services causes many patients to end up in the emergency room. In turn, the cost is handed off to Medicaid and the tax paying citizens making it seemingly pointless to not provide it

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To help cover this expense, Medicaid, a critical government assistance program, provides medical coverage to those low-income individuals and families. This ensures that essential health services such as doctor visits, hospital stays, prescription drugs, and other services are available. Medicaid is intended to promote the overall well-being who would otherwise face significant financial challenges to accessing critical medical treatment, limiting their capacity to seek higher education and job progression. Medicaid assists employees in this by providing a healthcare safety

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1236 Words | 5 Pages

Another recommendation is to change Medicaid so that states like New York and California won’t take as big a hit. These are two of the biggest states in our country, and if everyone in those states had to pay more it could creative massive problems for the state. There needs to be a balance between all the states and lowering the changing in funding per person will not only help California and New York, but also states like Oregon and Washington DC that were going to have to pay more. The last recommendation is to have create guidelines and rules for the states to follow. If states were allowed a lot of freedom and power for health guidelines, this would create problems for the health organizations.

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The eligibility rules for Medicaid have been criticized as confusing. Medicaid is a state administered program and its rules vary across states. That can present a significant problem to someone enrolled in Medicaid that moves across state lines. The 2012 Patient Protection and Affordable Health Care Act (ACA) included some changes in Medicaid enrollment procedures. President Lyndon Johnson was responsible for the creation of Medicare and Medicaid in 1965 (Berkowitz, 2008).

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The progression of Medicare and Medicaid show major differences from the start of the services to currently. The progression of the services is due to lawmakers eliminating, improvising, and creating new aspects to Medicare and Medicaid. The lawmakers are the ones that progress the services. “Therefore it is important to carefully consider the policy recommendations of the candidate to understand their vision for the future of Medicare” (Cubanski & Neuman, 2008, p.1). Medicare and Medicaid should be considered when electing lawmakers, candidates, because they are the ones that determine the progression and changes of Medicare and Medicaid.

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After the passage of the ACA, Minnesota was chosen to pilot a Medicaid program using ACOs to improve healthcare delivery because of the previous reforms that were made to the state’s Medicaid system. In 2008, the Minnesota state government passed the Health Care Reform Law which implemented the utilization of health homes to provide Medicaid services and a revision of the state’s quality and monitoring system of the Medicaid program (Edwards, 2013). The law was also expanded to use ACOs after the passage of the ACA, in order to provide more comprehensive care for Medicaid beneficiaries (Edwards, 2013). The use of the ACOs “forged a partnership to redesign the health care workforce and improve the coordination of the physical, behavioral, social, and economic dimensions of care” for Medicaid beneficiaries (Sandberg, Erikson, Owen, Vickery, Shimotsu, Linzer, Garrett, Johnsrud, Soderlund, & DeCubellis, 2014). To ensure the success of the program, the state also developed a safety-net program to ensure that Medicaid recipients would continue to receive quality care to meet their health care needs, if the pilot program

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528 Words | 3 Pages

During election seasons, someone who didn't know any better would think that the only DC real estate that is ever available or worth getting into is at 1600 Pennsylvania Avenue. Talk to sports fans in the area and they will tell you that the hot new DC real estate is the new Nationals Park in the Southeast section of the city. But the overall reality is that there's a whole lot more to DC real estate than simply historic and cultural centers and tourist destinations. Whether you're visiting the Washington, DC area or you already live in the metro DC area, chances are good that you have a sense that DC real estate has a lot to offer. You can't ride the Metro without seeing dozens of advertisements announcing the construction of new condominium

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States are being pressured to expand Medicaid to families earning up to $30,000 a year, just like the Affordable Care Act permits. While several respected governors have agreed to expand the program, many other governors and state legislators are cautious. These officials do not want to deny Americans their access to health care, however they do want to slow the expansion of a program that will provide them with limited access to quality care while destroying state budgets. One of the strongest arguments that can be made against the expansion of Medicaid is the fact that States simply can not afford it. The appeal to states to expand Medicaid is that the federal government will cover 100% of the cost through 2016 and eventually lowering to

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1227 Words | 5 Pages

Henceforth the different states will determine whether to accept or decline the federal organisation funds for extensions and advance the states healthcare programs. In most cases the obamacare will negatively affect the states because the costs of healthcare will be more expensive and the rising of private insurance. This will be expensive for the people living in those states to afford the private insurance especially for those relying on employers for insurance.

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