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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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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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