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BK8 Module 2 Healthcare Reform in the United States

BK8 Module 2 Healthcare Reform in the United States

Objectives


To discuss Medicaid Expansion
Analyze Coverage gap ( definition/issue/problem)
To ascertain how ACA has impacted Medicaid expansion in various states.
To comprehend the consequences of the coverage gap on low-income people.
To Compare Medicaid program in Texas and Minnesota
To determine the role of the ACA in widening or closing the coverage gap.
To asses solutions to closing the gap, including how healthcare care equity assist in closing the gap
HEALTHCARE COVERAGE GAP
Objectives
To discuss Medicaid Expansion
Analyze Coverage gap ( definition/issue/problem)
To ascertain how ACA has impacted Medicaid expansion in various states.
To comprehend the healthcare coverage gap that exists in various states
To comprehend the consequences of the coverage gap on low-income people.
To Compare Medicaid program in Texas and Minnesota
To determine the role of the ACA in widening or closing the coverage gap.
To asses solutions to closing the gap, including how healthcare care equity assist in closing the gap

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Medicaid is a public insurance program that offers free to low-cost health coverage to low-income families and special populations.
Participation in Medicaid is entirely
voluntary for the state, as no State is
forced to do so.
If a state chooses to join, it must
follow Medicaid statutes that require it to manage its own Medicaid programs (Mazurenko et al.,2018).
Medicaid expansion
Medicaid is a public insurance program that offers free to low-cost health coverage to low-income families and special populations such as elderly, children and dis-abled individuals.

This program was created in 1965 following the amendment of the Social Security Act.
It sees the federal government providing funds to the states, enabling them to provide medical assistance to residents.
States are not compelled to participate.
If a state participates, it should comply to Medicaid laws compelling them to administer their own Medicaid programs

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Following the amendment of comprehensive care reform (Affordable Care Act), Medicaid eligibility was expanded to cover more people.
Through it;
More individuals, including the
elderly, now have access to cheap
healthcare.
It has also resulted in a rise in employment.
–It has made a significant contribution to reducing the health coverage gap in states participating in Medicaid expansion.
MEDICAID EXPANSION cont..

Texas is one of 14 states that have not expanded Medicaid yet in accordance with the Affordable Care Act.
There are approximately 1.1 million
low-income Texans.
Many bills have been introduced
in Texas to compel the state to
abide by Medicaid standards.
Unfortunately, none of these have been implemented.
Adults in Texas are ineligible for government aid.
It records the highest population of uninsured individuals (Gostin,2019).
Texas opposes Medicaid expansion.

Texas is one of 14 states that have not expanded Medicaid in accordance with the Affordable Care Act.
There are approximately 1.1 million low-income Texans who might have benefitted from the Medicaid program.
Many bills have been introduced in Texas to compel the state to abide with Medicaid standards.
Unfortunately, none of these have been implemented.
Texas currently allocates 3% of its medical costs to Medicare.
The new bills once passed will increase this to 10%
Adults in Texas are ineligible to receive government care .
Medicaid expansion in Texas would help increase healthcare access

BK8 Module 2 Healthcare Reform in the United States

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Minnesota is one of the first states to embrace Medicaid Expansion.
Currently, the program covers
over 100% of poverty adults, irrespective of their special conditions.
It serves nearly 100 percent of poor adults, regardless of their special circumstances.
Minnesota Care, in addition to Medicare, is accessible to anybody earning up to 200 percent of the federal poverty level.
It has the lowest statistics uninsured population.
(Vickery et al.,2018).
Minnesota and ACA Medicaid expansion
Minnesota is one of the first states to embrace Medicaid Expansion.
Currently, the program covers over 100% of poverty adults, irrespective of their special conditions.
Currently, it covers for 240,000 low income adults.
It is one of the most progressive states with regard t Medicaid expansion.
Other than Medicare, Minnesota has the Minnesota Care that is available up to 200% poverty.
This makes it a great state, and has some of the lowest statistics 5% of uninsured population.

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Definition 
coverage gap arises whenever a substantial number of uninsured people are unable to obtain medical cover.
This gap is formed
when states opt out of
the Medicaid program.
Currently, approximately
2.2 million Americans are
ineligible for Medicaid.

Coverage gap

Definition
coverage gap arises whenever a substantial number of uninsured people are unable to obtain medical insurance.
This gap is formed when states opt out of the Medicaid program.
Many states are still refusing to expand Medicaid under the 2010 Affordable Care Act.
As it stands, over 2.3 million Americans are not eligible for Medicaid.
It is important to try and reduce the coverage significantly.

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Matters of coverage gaps occur in states that have not yet extended their Medicaid. This state falls in coverage gap since;
Medicaid is only available to certain income groups up.
Minority populations are highly afflicted
Promotes health disparities in care delivery.
Has an impact on the attainment of universal health care.

Coverage gap cont..
Issues with coverage gaps occur in states that have not expanded Medicaid. They include;
Impacts minority populations
Increases health disparity in provision of care.
Affects the achievement of universal health coverage.
Medicaid is limited to specific income groups up to 100% Federal Poverty Level

BK8 Module 2 Healthcare Reform in the United States

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Lower probability of receiving preventative and palliative treatment for chronic diseases.
Health initiatives aimed at
low-income healthcare customers
are being sidelined.
Increase of health disparities
Less affordable healthcare.
Poor access to care results in poor clinical outcomes among low-income families.
The Effects of the Coverage Gap on Low-Income Patients
People in the coverage gap, by nature, have constrained family income and lives in poverty, and so have;
Lower probability of receiving preventative and palliative treatment for chronic diseases.
Health initiatives aimed at low-income healthcare customers are being sidelined.
Increase of health disparities
Less affordable healthcare.
Poor access to care results in poor clinical outcomes among low-income families.

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Directly impacts one’s capacity to work due to poor health caused by a lack of access to care.
This population has a greater death rate as compared to other groups.
Increase the crime rate to find a means of paying for healthcare.
Increased coverage gap across this population.
The Effects of the Coverage Gap on Low-Income Patients cont..
Directly impacts one’s capacity to work as a consequence of poor health caused by a lack of access to care.
Increase level of crime to find ability to afford healthcare.
Poor commitment and investment in healthcare, especially in low income neighborhoods .
Higher death rates among this population compared to others.
Increase in coverage gap significantly across populations.

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Widening Coverage Gap
Mental health conditions and opiate addiction are being highlighted and integrated under the pretense.
Improved access to healthcare for low-income people.
Insurance punitive measures have been abolished.
Closing Coverage Gap
Allow the uninsured Hispanic population to be insured.
Provide more than 80% Medicaid eligibility to states that accept the expansion.
Decrease the incidence of health disparities in healthcare (Garfield et al.,2020).

BK8 Module 2 Healthcare Reform in the United States

Role of ACA in coverage gap
Widening Coverage Gap
Mental health conditions and opiate addiction being highlighted and integrated under the pretense.
Improved access to healthcare for low-income people.
Insurance punitive measures have been abolished.
Closing Coverage Gap
Allow the uninsured immigrant population to be insured.
Provide more than 80% Medicaid eligibility to states that accept expansion.
Decrease the incidence of health disparities in healthcare.

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Solutions to closing the coverage gap
Voters’ advocacy and
legislative efforts to promote
measures that eliminate the
coverage gap
conduct research that  influences
policy and includes voters and politicians
Collaborate with stakeholders to assess and create new coverage solutions for uninsured individuals(Rosenbaum et al.,2018).
Closing The Gap

Solutions to closing the coverage gap
Residents’ and voters’ advocacy and
legislative efforts to promote measures that eliminate the coverage gap
 conduct research that  influences policy and includes voters and politicians
Collaborate with stakeholders to assess and create new coverage solutions for the uninsured individuals.

BK8 Module 2 Healthcare Reform in the United States

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How Healthcare equity help close the gap
Educating healthcare practitioners about the significance of healthcare equity.
Collaboration between legislators,
providers, and other stakeholders
Collaborating with the community
to achieve healthcare equity and close the gap (Rosenbaum et al.,2018).
Closing The Gap Cont..

How Healthcare equity help close the gap
Health disparities have been drastically reduced as a result of Medicaid expansion.
Educating healthcare practitioners about the significance of healthcare equity.
Collaboration between legislators, providers, and other stakeholders
Collaborating with the community to achieve healthcare equity and close the gap
overemphasizing value of diversity and the need for in equality in healthcare.

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References


Garfield, R., Damico, A., & Orgera, K. (2020). The coverage gap: uninsured poor adults in states that do not expand Medicaid. Peterson KFF-Health System Tracker. Disponível em:. Acesso em, 29.
 
Gostin, L. O. (2019). Texas v United States: The Affordable Care Act is constitutional and will remain so. Jama, Article 321(4), 332-333.
 
Mazurenko, O., Balio, C. Agarwal, R., Carroll, A., & Menachemi, N. (2018). The effects of Medicaid expansion under the ACA: a systematic review. Health Affairs, Article 37(6), 944-950.
 
Rosenbaum, S., & Wilensky, G. (2020). Closing the Medicaid coverage gap: options for reform: A review of options that could make health insurance more affordable for 2.5 million poor working age adults who live in states that have not expanded Medicaid under the Affordable Care Act. Health Affairs, Article 39(3), 514-518.
 
Vickery, K., Bodurtha, P., Winkelman, T., Hougham, C., Owen, R., Legler, M., Davis, M. (2018). Cross-sector service use among high health care utilizers in Minnesota after Medicaid expansion. Health Affairs, Article 37(1), 62-69.
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