Position Paper-Medicaid Expansion
According to Healthinsurance.org (n.d.), Medicaid insurance targets people with low income and those with restricted financial assets. Medicaid insurance services are offered in all states of the USA. However, each state has unique rules that impact eligibility and coverage. The differences in rules and policies are attributed to the fact that State governments work in concert with the Federal government to fund and operationalize Medicaid (Healthinsurance.org, n.d.). Healthinsurance.org (n.d.) reports that Medicaid covers more than 90 million Americans. Furthermore, about 45 percent of the enrolled population comprises children (Healthinsurance.org, n.d.). Get in touch with us at eminencepapers.com. We offer assignment help with high professionalism.
A Description of the Issue
Patel et al. (2020) report that the Affordable Care Act (ACA) aimed to avail cost-effective healthcare to the majority of Americans. To accomplish this, ACA advocated for the expansion of the Medicaid program. In this context, states were expected to expand coverage to include individuals aged below 65 years with household earnings up to 138 percent of federal poverty levels (Lin et al., 2021). For instance, a person aged below 65 years with a household income of about $18,750 would be eligible for Medicaid in 2022 (Healthinsurance.org, n.d.). According to ACA, this expansion will be implemented in 2014 (Patel et al., 2020). However, the Supreme Court’s ruling allowed states to make independent decisions on whether or not to expand their Medicaid programs (Healthinsurance.org, n.d.). According to this ruling, states would not lose federal funding regardless of their decision on Medicaid expansion.
As stated earlier, state governments work in concert with the federal government to fund and operationalize Medicaid. It is worth noting that after Medicaid expansion, the Federal government incurs 90 percent of the cost for eligible individuals, whereas states incur 10 percent of the costs (Healthinsurance.org, n.d.). However, states incur higher costs for other individuals who do not benefit from Medicaid expansion (Healthinsurance.org, n.d.).
Norris (2023) reports that 38 states and the DC have embraced Medicaid expansion. According to Norris (2023), states that have not expanded Medicaid include Texas, Florida, Wisconsin, South and North Carolina, Georgia, Alabama, and Mississippi. Others include Kansas, Wyoming, and Tennessee (Norris, 2023). The ballot initiative has played a key role in expanding Medicaid services in states such as Idaho, South Dakota, Nebraska, Missouri, and Maine (Norris, 2023).
The Two Distinct Sides
Proponents argue that Medicaid expansion will improve access to healthcare services. It will enable people with low income levels to benefit from services offered by the Medicaid program (Guth et al., 2020). Examples of these services include outpatient services, laboratory and diagnostic services, in-patient services, maternal child health, and family planning services (Guth et al., 2020). Also, Guth et al. (2020) report that covered individuals enjoy long-term care services such as those provided in nursing homes.
On the other hand, opponents argue that Medicaid expansion is a costly initiative. According to them, the 10 percent cost share that states must pay is a costly plan. Medicaid expansion will suggest that they have to incur extra healthcare coverage costs. Also, opponents argue that Medicaid expansion will impede private insurance and lower their benefits. Furthermore, they argue that Medicaid expansion would compound the problem of prolonged waiting times created by the implementation of the ACA.
Background and Analysis
As mentioned earlier, ACA’s Medicaid expansion required states to expand coverage to include individuals aged below 65 years with household earnings up to 138 percent of federal poverty levels (Lin et al., 2021). States that have embraced Medicaid expansion receive 90 percent of federal funding to facilitate the expansion, whereas they pay 10 percent of the costs (Lin et al., 2021). Examples of states that have not upheld the expansion include Texas, Florida, Tennessee, South and North Carolina, Georgia, Alabama, and Mississippi (Norris, 2023).
Medicaid expansion has optimized healthcare in the USA. To begin with, Whitehouse.gov (n.d.) reports that the expansion resulted in a 41 percent increase in healthcare coverage. Furthermore, it has decreased the cases of disrupted coverage by approximately four percent (Whitehouse.gov, n.d.). Perinatal women have been the biggest beneficiaries of continuous coverage resulting from expanded Medicaid (Whitehouse.gov, n.d.). In addition, the expansion enabled low-income racial minorities to access Medicaid services (Whitehouse.gov, n.d.). For instance, Medicaid expansion resulted in a 30 to 50 percent increase in coverage rates for Latinos and African Americans in the expansion states (Whitehouse.gov, n.d.).
Secondly, Medicaid expansion increased access to care. The expansion enabled low-income individuals to access quality, affordable healthcare services. Whitehouse.gov (n.d.) reports that residents of expansion states can access regular care and primary care physicians easily compared to those found in states without expanded services. Also, the expansion has enabled people to access diverse healthcare services such as the management of substance use disorders, management of chronic disorders, and access to prescription medications (Guth et al., 2020). For example, Guth et al. (2020) report that Medicaid expansion resulted in a 24 percent increase in the use of smoking cessation drugs and an 18 percent increase in admissions to opioid specialty management facilities. As such, Medicaid expansion improves patient outcomes by allowing them to access timely, affordable, quality healthcare.
Thirdly, Whitehouse.gov (n.d.) reports that Medicaid expansion did not increase the net spending of states on healthcare. Furthermore, it did not reduce state expenditure in other sectors. This is attributed to the fact that the expansion lowers states’ expenditures on mental health and reduces uncompensated claims for healthcare facilities (Whitehouse.gov, n.d.). Furthermore, Guth et al. (2020) report that Medicaid expansion improved financial stability, as evidenced by an increase in food security by about two percent and a reduction in health-related poverty levels by about one percent.
On the other hand, Medicaid expansion is impeded by some concerns. Firstly, it is likely to affect private insurance because it seeks to expand the role of the government in providing coverage (King, n.d.). Secondly, some states may not be able to afford the funds needed to expand their programs (King, n.d.). Thirdly, the expansion restricts states from selecting specific populations to be covered and the benefits to be offered (King, n.d.). Fourthly, the states that embrace expansion are not allowed to limit eligibility in the future (King, n.d.).
Pros and Cons
Pros
Medicaid expansion will increase the number of people who qualify for and benefit from Medicaid services. States control the eligibility for Medicaid and may limit some low-income individuals from accessing these services (Lin et al., 2021). Secondly, the expansion positively impacts the state economy and offers financial security. For instance, Whitehouse.gov (n.d.) reports that it increases food security by about two percent and reduces health-related poverty levels by about one percent. It enables low-income individuals to channel their expenditures to other needs because they can access affordable healthcare services. Thirdly, the expansion will lower the percentage of people who are not insured (Lin et al., 2021). The low-income population accounts for the biggest percentage of the people who are not insured. As such, the expansion will enable this population to access coverage and lower uninsured rates. Fourthly, Medicaid expansion will not be costly for the states compared to federal spending (Whitehouse.gov, n.d.). In this context, states will incur 10 percent of the costs, whereas the federal government will incur 90 percent of the costs (Healthinsurance.org, n.d.). Fifthly, the Medicaid expansion will promote beneficence by ensuring that more people access quality healthcare.
Cons
Firstly, Medicaid expansion is likely to affect private insurance because it seeks to expand the role of the government in providing coverage (King, n.d.). Secondly, some states may not be able to afford the funds needed to expand their programs (King, n.d.). Thirdly, the expansion restricts states from selecting specific populations to be covered and the benefits offered (King, n.d.). Fourthly, the states that embrace expansion are not allowed to limit eligibility in the future (King, n.d.). Furthermore, the expansion is likely to compound the problem of prolonged waiting times created by the implementation of the ACA.
Identity and Description of the Target Audience
Medicaid expansion is relevant to various stakeholders. They include members of the Senate, members of Congress, healthcare practitioners, and representatives from the Centers for Medicare and Medicaid Services (CMS). Members of the Senate and Congress are relevant because they are involved in legislation. They influence policy formulation and can impact Medicaid expansion in states that have not embraced these provisions. Notably, it targets senators and congresspersons from Texas, Florida, Wisconsin, South and North Carolina, Georgia, Alabama, Mississippi, Kansas, Wyoming, and Tennessee. These states have not implemented Medicaid expansion. Further, healthcare practitioners are relevant stakeholders because they are involved in patient advocacy and providing patient-centered care. Familiarity with the benefits of Medicaid expansion will enable them to collaborate with members of Congress to make legislation that allows expansion. Finally, representatives from the CMS are relevant because they are dedicated to promoting health equity, optimizing health outcomes, and availing health insurance.
An Explanation of My Opinion
I am a proponent of Medicaid expansion. All states should uphold ACA’s Medicaid expansion. This is relevant because it will increase the insured population and increase access to care by allowing the low-income population to access affordable health care. Access to care is associated with improved patient outcomes and high patient satisfaction levels. The absence of expanded Medicaid services limits the ability of low-income populations, racial minorities, and vulnerable populations to access quality healthcare. As such, the remaining twelve states should expand their Medicaid services.
Supporting Evidence
The Medicaid expansion improves coverage and optimizes access to care. As mentioned earlier, Whitehouse.gov (n.d.) reports that the expansion resulted in a 41 percent increase in healthcare coverage. Furthermore, Medicaid expansion has decreased the cases of disrupted coverage by approximately four percent, and perinatal women have been the biggest beneficiaries of continuous coverage resulting from expanded Medicaid (Whitehouse.gov, n.d.). In addition, Whitehouse.gov (n.d.) reports that residents of expansion states can access regular care and primary care physicians easily compared to people found in states without expanded services. For example, Guth et al. (2020) report that Medicaid expansion resulted in a 24 percent increase in the use of smoking cessation drugs and an 18 percent increase in admissions to opioid specialty management facilities. For instance, Medicaid expansion in Wyoming, Tennessee, Mississippi, Alabama, and Florida will increase coverage to 34,000, 339,000, 217,000, 340,000, and 1.3 million more people, respectively (Norris, 2023). These data confirm that Medicaid expansion in the twelve states will impact healthcare positively by allowing more people to access affordable care.
Conclusion
ACA’s Medicaid expansion aimed to improve access to care by providing coverage to people with a household income of 138 percent of the poverty level. Reports from expansion states indicate that the initiative lowered uninsured rates, improved access to care, and promoted financial stability. However, following the Supreme Court ruling, some states, such as Mississippi, Texas, and Kansas, have not expanded their Medicaid services. Consequently, this has impeded access to care for the low-income population in these states. All states should uphold ACA’s Medicaid expansion to increase access to care by the low-income population.
References
Guth, M., Garfield, R., & Rudowitz, R. (2020). The Effects of Medicaid Expansion under the ACA: Studies from January 2014 to January 2020. https://www.kff.org/report-section/the-effects-of-medicaid-expansion-under-the-aca-updated-findings-from-a-literature-review-report/
Healthinsurance.org. (n.d.). Medicaid. https://www.healthinsurance.org/glossary/medicaid/
King, M. (n.d.). Medicaid in a Nutshell. https://www.King/hhs/hdfs/fii/wp-content/uploads/2015/07/s_wifis22c01.pdf
Lin, Y., Monnette, A., & Shi, L. (2021). Effects of Medicaid expansion on poverty disparities in health insurance coverage. International Journal for Equity in Health, 20(1), 1–11. https://doi.org/10.1186/s12939-021-01486-3
Norris, L. (2023). A state-by-state guide to Medicaid expansion, eligibility, enrollment, and benefits. https://www.healthinsurance.org/medicaid/
Patel, M. R., TerHaar, L., Smith, A., Tariq, M., Worthington, K., Hinton, J., & Lichtenstein, R. (2020). Knowledge of Health Insurance Terms and the Affordable Care Act in Racially and Ethnically Diverse Urban Communities. Journal of Immigrant and Minority Health, 22(3), 456–466. https://doi.org/10.1007/s10903-019-00924-3
Whitehouse.gov. (n.d.). The Effects of Earlier Medicaid Expansions: A Literature Review. https://www.whitehouse.gov/cea/written-materials/2021/06/22/the-effects-of-earlier-medicaid-expansions-a-literature-review/#:~:text=Medicaid%20expansion%20has%20been%20associated,et%20al.%2C%202017).
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– # 8 Provide a clear explanation of your opinion based on your background analysis and the pros and cons.
Position Paper-Medicaid Expansion
*My opinion on Medicare expansion is that I am for “all” states participating so that everyone has access to
healthcare coverage of some type*
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