Proposed Changes Of Medicaid Expansion On Florida And Other States

Delivery System Reform Incentive Payment Program (DSRIP) -- local programs working to improve health care delivery costs and outcome.

The purpose of the bill is to reduce state Medicaid disproportionate share hospital (DSH) allotments annually from fiscal year (FY) 2014 through FY 2020. The reduction will occur “at the same time as the Marketplace and Medicaid provide increased coverage options that will reduce uncompensated care levels for hospitals. State Medicaid programs make DSH payments to qualifying hospitals that serve a large number of low-income individuals.”

These new entities included critical access hospitals (CAH), freestanding cancer centers, pediatric hospitals, community hospitals, and rural referral centers. Due to this expansion, “there have been more than 1,100 of the 1,600 eligible under the new provision that have enrolled in the 340B program. Currently, these entities account for about 9 percent of the total 340B drug sales and thus represent a notable increase in the 340B program” (Vandervelde, 2014). The ACA’s expansion of Medicaid will continue to create newly eligible entities. It has been estimated that as many as 350 hospitals could become eligible entities by 2019 bring in an increase sale for the 340B program of $1.4 billion. The more patients that are approved for Medicaid, the more they will seek treatment in return increasing the number of hospitals that are eligible for the 340B

Seven of the thirty-three states that adopted Medicaid expansion obtained section 1115 Medicaid demonstration waivers. These waivers allow states flexibility in operating state-specific Medicaid programs beyond what is available under current law. Indiana is among the seven states that are using a Federal waiver to continue its seven-year-old Healthy Indiana Plan instead of implementing the traditional Medicaid expansion offered by the ACA. The Healthy Indiana Plan, also known as HIP 2.0 since 2015, is a health insurance program for uninsured adults with income at or below 138 percent of the Federal poverty level.1 Indiana Medicaid has three programs for patients with serious mental illness, emotional disturbances, and substance use

In the article, This Is What Happens When Your State Blocks The Medicaid Expansion Jonathan Cohn discusses the impact that the Affordable Care Act has had on the percentage of people that have health insurance in the United States. Cohn goes in depth about what the Affordable Care Act is and why it has been so beneficial to the states that have adopted it, most specifically the expansion of Medicaid. Cohn also addresses the loophole that allows states to opt out of the federal program due to a Supreme Court ruling in 2012 that allows states to block the Medicaid expansion. The new Medicaid expansion has helped lots of Americans get access to health insurance that they would not have had access to otherwise, but some states are not taking

Effective May 30, 2018, the Virginia General Assembly approved Medicaid Expansion as a part of the 2019-2020 budgets. Virginia’s Governor Northam signed this approval into law on June 7, 2018, and as a result, approximately 400,000 low-income adults now qualify for health insurance (Norris, 2018). The General Assembly vote ended a “long-running partisan stalemate” with some Republicans joining the Democrats in support (The Associated Press, 2018). The Kaiser Family Foundation reports that Virginia is the 33rd state to approve the Medicaid Expansion (The Associated Press, 2018).

Throughout the early 1980’s and 1990’s the Federal Medicaid program was challenged by rapidly rising Medicaid program costs and an increasing number of uninsured population. One of the primary reasons for the overall increase in healthcare costs is the

As a health policy analyst for the state of Texas which has not elected to expand Medicaid as part of the Affordable Care Act (ACA) and now has been notified that the state leaders have taking into reconsideration their recent decision during an upcoming session in order that we begin gathering data on the benefits of adapting the Medicaid expansion. As a health policy analyst our goal is to assure data quality, interpret data, and discover new information in the data. Medicaid is a federal and state partnership with shared authority that is a health insurance program for low-income individuals, children, their parents, the people with disabilities and the elderly. Nationally Medicaid covers health care for over 72 million people. Even though participation is optional, all 50 states participate in the Medicaid program. However, Medicaid benefits eligibility varies widely among the states all states must meet federal minimum requirements, but they have options for expanding Medicaid beyond the minimum federal guideline (http://www.ncsl.org/research/health/affordable-care-act-expansion.aspx). In this research we will identify the state of interest which is Texas, compare the state’s decision, determine the alternate approaches to expanding access and provide a recommendation on whether or not the state should opt in to the Medicaid expansion.

Why is Medicaid a huge topic in Texas and how does it relate to me? This is one important question to consider. Well this paper will help shed light to the matter and illustrate the urgency for action. Just recently Texas had an option to extend Medicaid, but hastily denied. Medicaid Expansion was part of the Obama care reform in which the federal government gave the 52 states an offer to expand the current Medicaid in was that it would include the coverage of low income adults not only children. The latest on the issue is Texas had agreed on a deal but only temporarily. The agreement on the reform has given Texas some light, but not enough to reach through the other side of the tunnel. Eventually, Texas

The potential opportunity for the state to opt into the Medicaid expansion is the fact that low-income citizens will be insured. The decision of the state to opt into the Medicaid expansion will also impact the state’s budget, and this is the main challenge (Frakt, 2013). The government will cover majority of all the cost even as Medicaid expansion provides coverage for the low-income uninsured citizens. Expansion of the Medicaid is also a broken system that has poor outcomes, not severe federal strings, high inflation and no incentive for the personal responsibility of the citizens who

The federal Affordable Care Act (ACA) together with Illinois Public Act 98-104 will increase access to health coverage as a critical step toward improving the health of the people of Illinois (HFS, 2014). Illinois residents can use the health insurance marketplace, but easily compare health plans and see what costs are better for them before buying a plan. Every plan is covered essential benefits such as preventive care, doctor visit prescription drugs, maternity care, emergency services, hospital stays and more. Residents can succeed for financial help through the Marketplace to lower monthly premiums and out-of-pocket costs. Insurances companies’ cannot reject residents that apply for coverage for they are sick or have a preexisting health condition. People can receive Medicaid for the first time low-income adults who are legal residents, regardless of parental or health status may be eligible for health coverage through Medicaid. Adults that have incomes at or below 138% of the federal poverty level on the family may be eligible. Application for benefits Eligibility is an easier to apply for Medicaid, SNAP, and the Medicare Savings. Indiana purpose of healthcare reform for residents is enrolling adults in its new Healthy Indiana Plan. The plan was offered in the state of Indiana. With the plan,

In a traditionalist state, such as Texas, the financial toll that Medicaid would have on its taxpayers was on the frontlines. The Texas legislature was worried about whether or not its taxpayers would face a tax increase to cover the increased cost of those covered by Medicaid. These taxpayers would inadvertently pay for the hospital bills of those who are uninsured in Texas through an average $1,800 rise in the cost of their premiums (Rapoport, 2012). In support of expanding Medicaid, Texas would receive federal funds in order to ease the cost that accompany the expansion. Since Texas decided not to expand Medicaid, Texas “would be leaving billions and billions of federal dollars on the table” according to Anne Dunkelberg (Rapoport, 2012). Not only does this monetary incentive give Texas an extra push to participate towards expanding Medicaid but it would also help the residents of the state to get insured. Texas legislators understood that this monetary incentive would not fully cover the cost of the newly enrolled Medicaid recipients. In the end, they would have to rework the annual budget and increase taxes in order to cover these extra recipients.

Also by rejecting the Medicaid expansion community-based providers, including hospitals are casualties. Hospitals will continue to provide care to the uninsured without sufficient compensation, increasing shift costs to the privately insured. This also has a chilling effect on enrollment in private insurance plans through the new federally facilitated marketplace. Opposing the Medicaid expansion also ignores the real needs of the uninsured and the massive financial burden shouldered not only by the hospitals but taxpayers and businesses. (Stultz, 27)

Medicaid is a social health care program that covers nearly 60 million Americans, including children, pregnant women, seniors, parents and individuals suffering with disabilities. Medicaid is the biggest source of funding for health related services and medical needs for the people with low income in the United States. This program is funded jointly by the state and federal level governments, but it is the state’s responsibility to manage this program. The Medicaid program is not a required program that states have to use, but all 50 states have implemented this program. With the introduction of the Affordable Care Act (ACA), and its passing in 2010, the ACA unveiled its plans to expand Medicaid eligibility to nearly all low-income adults as an addition to the other groups that fall into the Medicaid eligibility. The Medicaid program had “many gaps in coverage for adults” because it was only restricted to the low income individuals and other people with needs in their own specific category. In the past, the majority of the states who had adults that did not have children dependent on those parents were not eligible for Medicaid. These low income adults without dependent children would be without medical insurance assistance before the ACA was introduced. Medicaid is now available to all Americans under the age of 65 whose family income is at or below the federal poverty guideline of “133 percent or $14,484 for an individual and $29,726 for a family of four in 2011” (NSCL).

Research conducted indicates that this method of fund raising will increase the state resources by approximately 11% and as a result more low income individuals and families will have access to appropriate health services to manage their conditions (CPBB, 2015). It is proposed that the federal and state government allocate the funds obtained towards the Medicare and Medicaid programs. This will expand the services offered by these programs and with additional funds; they can provide individuals with access to specialized care and services needed to manage their condition. However, it is imperative that the federally established poverty guideline be periodically re-evaluated, to increase the percentage of individuals that are eligible for subsidized health care. The idea is to have individuals with chronic illness sign up for the packages that offer the services and care needed. With the aforementioned, proposal for increasing both the federal and states health care budget, the goal of providing all Americans with access to health care, will become realistic. The goal of the ACA is to ensure that everyone has access to healthcare, so by providing government assistance to individuals in need to manager their illness will ultimately reduce the long term health care cost. Chronically