The Medicaid Health Care Program

Introduction

Medicaid was formed in the year 1965 as a public insurance program to provide health coverage to families and individuals that earned low incomes. The people that the Medicaid insurance program covers include children, parents, pregnant women, the older people and people living with disabilities (Stevens, & Stevens, 2017). The Medicaid program has been founded jointly with the federal government and the state governments. Each state within the U.S. operates its own Medicaid program in accordance with the federal government guidelines. Stimpson and Wilson (2018) point out that in the year 2019, the Medicaid health coverage program helped 97 million families in the United States within that said year. To break it down, the program is said to have helped 32 million children, 28 million adults, 6 million older people, and nine million people with disabilities who essentially had low incomes. The spending of the Medicaid program on children seems to be the largest compared to the other cluster groups. Although the Medicaid program was started in the United States a while ago, it has not sufficiently penetrated all the states and therefore there may be need to establish ways of ensuring its spread.

California State has the highest number of Medicaid enrolments followed by New York. When calculated as a percentage of the population, New Mexico is arguably the state with the highest number of enrollees of the Medicaid program. The purpose of the essay is to evaluate the status of the Medicaid program. The essay will go further into establishing the advantages and disadvantages of the program. Also, the present essay will establish the opportunities that the program provides to the community and the specific challenges that it brings forth. This write-up will further recommend strategies to counter disadvantages and challenges presented by the Medicaid health program.

Discussion

The Medicaid program was not formed to serve all types of people - rather there are certain categories of people who are eligible to benefit from the program. One of the groups eligible for the program are pregnant and uninsured women. However, a woman who enrolls while pregnant may not eligible for the program. According to Stimpson and Wilson (2018) the other eligibility factors that affect pregnant women include their household size, immigration size as well as income. Women who wish to benefit from the program would have to visit their states website on pregnancy related Medicaid and establish their coverage limits according to their conditions. Pregnant women who get covered by Medicaid program also get their children covered.

Children and teenagers are also eligible for the program and especially if their families earn a low income. Children and teenagers encompass all boys and girls below 18 years old without any insurance coverage. Teenagers who are also living on their own are also covered. There are states that cover children up to the age of 21.

The third group of people is people who are 65 years and older. Currie and Duque (2019) are of the opinion that despite the economic improvements in the United States over time, there are many elderly Americans who face challenges in relation to meeting their living expenses. The authors further indicate that 41% of the nations population of elderly people have low incomes - which is below twice the federal governments poverty level. In the year 1994, the federal poverty level in the United States was $7,100 p.a. for a single adult and $9,000 for a couple. 12% of the elderly population in that year was below the poverty level (Rowland, & Lyons 1996). As a result, out of these, 5.9 million elderly poor people had an opportunity to benefit from Medicaid. The elderly people resided in nursing homes and received help from the Medicaid program.

The other group of people that benefit from the Medicaid program are people living with disabilities. People living with disabilities may either be born with disabilities or may become disabled at some point of the lives. People with disabilities are prone to many challenges of even acquiring opportunities in the society because they are sidelined. Such individuals may not get an education and meaningful jobs could be an issue. Most, hence, end up living in poverty. For persons diagnosed with developmental and intellectual disabilities, Medicaid acts as a source of the much needed funds. Medicaid services their activities and ensures that they live normal lives. It is important to note that about 12% of adults in the United States have a disability (Hung,Ross, Boockvar, & Siu 2011). The Medicaid program provides both short term and long term care services in an attempt to ensure that the needs of persons with disabilities are met. Some of the services that Medicaid provides to such people include preventive care, nursing home care and medical treatment for various illnesses. The Medicaid program helps people with disabilities in finding and holding jobs.

As earlier suggested, Medicaid is a social insurance program which covers basic healthcare needs for people who earn low income. The program is therefore designed to cover the health costs of low-income earning individuals. Depending on the State that the program is institutionalized, Medicaid may cover different health care services. There are however mandatory...

311). The Medicaid health program also covers both optical and dental services to eligible individuals up to a limit given by specific states. This is because each state is required to run is own program, but the government provides half of the funding for the Medicaid services needed.

The optional Medicaid benefits that eligible individual benefit from include the prescription of drugs, physical therapy, clinic services, occupational therapy, respiratory care services, eye glasses, dentures, personal care and practice services. The Medicaid senior program coverage however goes further into providing extra services to individuals in their homes including skilled nursing care, transportation services, home delivered meals, healthy eating and physical therapy.

Although the United States government is at the forefront in ensuring nationwide insurance coverage, many individuals in the United States are ineligible for Medicaid because of their immigration status. Such groups of people are temporary protected by the federal government.

The Medicaid program has played a great role in insuring low-income families in the United States. This has worked out well because of the support of the Healthcare Act in the country. As of April 2020, Medicaid eligibility has expanded immensely. 35 States in America have implemented the Medicaid expansion program in an effort to serve the poor and low-income earning adults. It is suggested that by the year 2029, the Medicaid health program will serve an extra 14 million individuals in efforts to assist them access affordable and comprehensive health coverage. By the year 2021, 39 states in America had implemented the Medicaid program, leaving out only 12 states which have not adopted the Medicaid expansion program. There are, however, states such as Missouri and Oklahoma which have adopted the program but have not implemented the expansion.

Advantages and Disadvantages of Medicaid Program

A study was conducted by Reddy, Finley Posey & Rohack, (2012) to establish whether expanding Medicaid would help manage health care in Texas. The researchers reviewed the Texas Medicaid program and the potential benefits it had on federal healthcare. The research was conducted through online and state review. The study concluded that if the Medicaid program was conducted in a proper manner, it would result in the responsiveness of its recipients. It would also meet the needs of the enrollees while at the same time reducing the costs of the state.

Stimpson & Wilson (2018) also conducted a study to establish Medicaid expansion and improved health coverage in the United States. In the study, the authors argue that there have been racial and ethnic disparities when it came to Medicaid health coverage. The study uses data from the year 2010 to 2015 to establish the effectiveness of the Medicaid program. The study establishes that the Medicaid program has resulted to insurance expansion among the US natives. Non-natives have, however, had problems accessing the health program. There have also been disparities when it came to assisting the non-natives.

Insurance is a term that means the pooling of resources to survive a risk. The Medicaid program has pooled resources to reduce health risk in the United States. In Texas, there are Medicaid waivers supported by the Medicaid program. An example of a Medicaid waiver is the 1115 waiver. This type of waiver works to finance and benefit human services. Waivers are one of the advantages of the program because they are funded by the government hence reducing the costs for the Medicaid program. The reduction of costs in the program help reduce inefficiency (Schlenker & Huber 2015). The healthcare sector is expensive to manage and finance. However, Medicaid waivers come in and help improve efficiency while providing health services to citizens.

Quinn, Weimar, Gray & Davies (2016) carried out a research to establish the clinical outcomes of the Medicaid program in the United States. The expansion and levels of influence of the Medicaid program are making it a purchaser of quality care in the present and also in the future. The research conducted views Medicaid as a program that is influential both for obstetric and pediatric care. Some of the positive outcomes of the Medicaid program also include early elective deliveries, reduced mortality rates, patient satisfaction and emergency department visits. The…