Medicaid (Essay Sample)

Student's Name Professor's Name Course Date Medicaid Healthcare is among the most essential sectors in the United States since it deals with the health and well-being of Americans. It offers appropriate healthcare and preventive services to ensure that people maintain proper health to engage in their daily activities. When the people are healthy, they can engage in different economic activities, enhancing the country's economy. The delivery of appropriate medical services is done through the collaboration of different stakeholders. The government is among the main stakeholders in the healthcare environment. It develops and enforces relevant policies to create a healthy nation. The policies guide the operations of the healthcare providers and organizations in the healthcare environment to ensure that the citizens receive the most appropriate care to address their health complications and maintain their well-being. Healthcare organizations must comply with all government policies in the healthcare regulatory environment to continue their healthcare delivery operations. Medicaid is among the healthcare policies administered by the American government and considerably affects healthcare access. This paper will assess different aspects of Medicaid, including eligibility, expansion, impact, and challenges. Medicaid entails a joint state and federal program that helps cover the healthcare costs for some individuals with limited resources and income. It offers health coverage to many Americans, including eligible low-income earners, pregnant women, children, older people, and disabled individuals (Crowley et al., P 2). The national government has general policies that all state Medicaid programs must adhere to, but each state has a different program. Therefore, the Medicaid benefits and eligibility can be different among the states. Medicaid provides benefits not covered by Medicare, such as personal services and nursing home care (Allen et al., P 6). Individuals with Medicaid coverage do not pay anything for covered healthcare services but may be required to incur some costs for some services or items. The government implemented the Medicaid program to improve the accessibility of care among the people in the US. This came as a result of the increased struggle of some populations, especially the vulnerable communities, to access people medical services in the healthcare system (Lin et al., P 3). Implementation of Medicaid was a significant way for the government to revolutionize the healthcare industry by ensuring that low-income and other vulnerabilities are not barriers to healthcare access, helping create a healthy nation. As a joint state and federal program, Medicaid and the CHIP (Children's Health Insurance Program) offer health coverage to more than 77.9 million Americans, including pregnant women, children, seniors, parents, and individuals with disabilities (Medicaid). It is the single largest source of medical coverage in the US based on the number of individuals covered. To participate in Medicaid, various eligibility criteria are used, including the following. Among these criteria is financial eligibility. Medicaid eligibility concerning the income is based on the MAGI (Modified Adjusted Gross Income). MAGI is an essential aspect that helps determine the financial eligibility for Medicaid, premium tax credits, CHIP, and cost-sharing reductions available in the insurance marketplace in the healthcare environment. Utilizing a particular set of income counting policies and a single application across different programs makes it easy for people to enroll in Medicaid and other associated programs (Sugar et al., P 2). The MAGI-based approach considers the tax filing and taxable income relationships to determine a person's financial edibility for a Medicaid program. The approach does not allow for income disregards that are different based on the eligibility group or the state and does not allow for resource or asset tests. Non-financial eligibility is another considerable criterion used to determine whether individuals qualify for Medicaid in the US. To gain Medicaid eligibility, people must meet specific criteria that are not associated with finances. In terms of residence, Medicaid beneficiaries must stay in the state where they receive medical coverage (Medicaid). The eligible candidates must also be American citizens or specific qualified non-citizens, such as legally permanent residents. Some states also set limits based on the age, parenting and pregnancy status of the candidates. After gaining Medicaid eligibility, coverage is effective on the application date or the first day of the application month. Retroactive benefits may also be covered for up to three months before the application month if the person would have been eligible during that period had they applied. The effective coverage date occurs at the end of the month when an individual no longer meets the eligibility requirements. States administering Medicaid can develop a "medically needy program" for people with considerable health needs and high-income levels, which prevents them from qualifying for Medicaid under other edibility groups (Keohane et al., P 713). Medically needy people can also be eligible for Medicaid by spending down an income above the standard if they have medically needy income in the state. People spend down by catering for expenses for remedial and medical care for which they do not have medical coverage (Crowley et al., P 3). After spending down, the individual qualifies for Medicaid, and the program pays the medical services exceeding the expenses a person had to incur to be eligible. Medicaid expansion is a crucial aspect that has influenced healthcare delivery and access in the US. It was created by the Affordable Care Act (ACA) of 2010 to provide health coverage to more Americans (Sun et al., P 1). Under this expansion, Medicaid revised its eligibility criteria by including adults under 65 with incomes up to 138% of the FPL (Federal Poverty Level). Before ACA, Medicaid was unavailable to people without disabilities under 65 years unless they had a minor kid (Medicaid). The income caps for eligibility as a caretaker or a parent were also very low. More Americans, especially low-income adults, can access health coverage through Medicaid expansion. States were expected to develop and implement relevant approaches to facilitate the successful implementation of the Medicaid expansion (Allen et al., P 8). Medicaid expansion made it easy for more people to access quality medical services to address their health complications, regardless of their income levels. It is a crucial step toward ensuring that all the people in the US have proper access to quality and timely healthcare services. Apart from patient benefits, Medicaid expansion also benefited healthcare organizations and providers. Medicaid expansion promoted the financial performance of healthcare organizations and other providers (Sun et al., P 2). The financial effect differs based on the hospital type and the medical services offered to clients. The increase in financial performance comes from the rise in demand for some medical services as Medicaid covers them. Medicaid and its expansion have considerable impacts on the healthcare environment, which includes the following. Among the significant impacts is increasing healthcare coverage. Medicaid increased the health coverage rate in the US by reducing the uninsured rate. It provides medical coverage to a substantial number of people who meet the set criteria. As noted earlier, Medicaid and CHIP offer health coverage to more than 77.9 million Americans (Medicaid). Increased health coverage makes it easy for people to get quality care to address their health complications. Another considerable impact of Medicaid is increased healthcare access. Healthcare access entails people's ability to get proper medical services when needed. A substantial factor that reduces healthcare access in the US healthcare system is the high cost. It is challenging for many people to afford the expensive healthcare services in the healthcare sector (Sugar et al., P 3). Medicaid addressed this issue by reducing the financial burden people incur when accessing medical services. Consequently, it improves healthcare access and promotes the health of the people. Another significant impact is reducing healthcare costs. The high cost of medical services is among the factors hindering people's ability to get proper care in the US healthcare system. Medicaid caters to the medical cost of the eligible candidates when accessing healthcare services (Crowley et al., P 4). As a result, it reduces the cost that the people are expected to pay for their treatment, improving their ability to attain optimal health. The other significant impact associated with Medicaid is that it offers more health benefits to eligible individuals. As noted earlier, Medicaid provides benefits not covered by Medicare. Medicaid covers more healthcare services such as long-term care, nursing home care, eye exams, and dental care (Allen et al., P 6). Some patients, especially elderly individuals, spend most of their time in nursing homes since they require continuous healthcare services and monitoring. Staying in nursing homes for an extended period can be costly to the patients and families based on the high costs of medical services in the US. By addressing this issue, Medicaid has a considerable benefit since the program covers long-term and nursing home care for elderly patients. The program ensures that the patients do not experience a financial burden for staying in long-term care facilities. Addressing health inequality is another substantial benefit of Medicaid in the US healthcare system (Sugar et al., P 5). Health inequality entails unfair and unequal access to healthcare services based on the differences among the people in the population. It is a signi...