Introduction
Medicaid is the public health care system used by the majority of citizens in the US. Health care services have become very expensive in recent days with the price tag of medical services expected to be on a steady rise for the next couple of years. Most citizens are burdened with the heavy cost of medical services. Various states are looking into means by which the Medicaid health plan can be made available to as many citizens as possible. Qualifications for the Medicaid health care plan is based on various factors such as income, disability, family, status and disability among others. The government should not feel obligated to comply with the Medicaid expansion program.
Definition of terms
Universal healthcare is a system which provides all citizens of a certain country with health care services as well as financial protection. Universal health care is also known as universal coverage. In the US health care market, patients are the buyers while Medicaid acts as the intermediary between the patients and the health care service providers. The US health care market does not abide by the rules of the free market as most patients have limited access to valuable information such as market prices. Prices in the health care sector are not dependent on the laws of supply and demand. The private health care has formed strong alliances which hinder competition from penetrating the US health care market.
Literature review
The Affordable Care Act was put into test in the famous case of National Federation of Independent Business V. Sebelius in 2012. The Affordable Care Act provides requires that all citizens have a right to affordable health care services. The Supreme Court endorsed the legality of the Act by requiring all the US citizens be provided with universal health care coverage. The Supreme Court required that the congress provide funds to extend Medicaid services even to those people who had were earlier on considered as ineligible for the Medicaid program. This was later changed when seven judges limited the powers of the congress to spend the state’s fund to implement the Act . If the state had gone ahead to uphold the Affordable Care Act, the state would have added an extra 16 million people to the Medicaid program by the year 2019.
Medicaid is the leading insurance provider in the United States. In 2012, the program covered over 70 million citizens. Its average expenditure in 2012 was 430 billion USD, 60% of which belonged to the federal government. Medicaid health program accounts for up to 20% of the government’s budget on an annual basis, while other vital sectors such as the education sector accounts for 8% of the budget . Medicaid was enacted in 1965 and since then, governments have been participation in the program voluntarily. According to the enactment, no state is obliged to participate in the program but most of them are participating in the program, despite the pressure to drop out of the program due to the extremely high cost of health care services. At the time when the Medicaid program was rolled out, it was meant to serve those who were socially disadvantaged. With time, the government has found itself responsible for more citizens than it had anticipated to, with acts such as the Affordable Care Act (ACA) looking to extend these provisions to all the American citizens. The government has found itself overburdened with these responsibilities while more people keep advocating for a universal health care system.
Since January 2014 the United States has been looking to expand Medicaid services to more of its citizens by relaxing the qualifications for eligibility. This plan is expected to extend the cover to tens of millions of US citizens. ACA was passed in March 2010, and since then 6 states have embraced the Medicaid expansions. These states include Districts of Columbia, Connecticut, New Jersey, California, Minnesota and Washington, which have expanded the Medicaid services to adults who are low income earners . These expansions were dependent on the income levels and are intended to cover individuals below the poverty levels. The Supreme Court gave the states the option to expand Medicaid services to its citizens, under certain guidelines. Before the Supreme Court allowed these states to participate voluntarily, most states were reluctant to Medicaid expansion.
Since the rolling out of the programs in the six states, membership has increased tremendously, and the expansion includes both new individuals and others who were enrolled by local insurers. Various lessons can be derived from the expansions that have been rolled out. Large numbers of enrollment is taking place in states which had insurance providers to cater for adults with low income. Prediction into the cost and benefits of these expansion is difficult. Coverage and accessibility is still a barrier to health care services even with the expansion of the Medicaid health program. Some adults with low income are faced with harsh social surroundings such as housing, which continue to limit their ability to access health care facilities even when they are insured. Substance abuse is also another barrier to universal health care since such communities will require specialized health care services and facilities . The federal government is also experiencing difficulties in verifying citizens who qualify as low income adults, with some individuals who were initially capable of affording health care services applying for the Medicaid expansion.
Limitations
The short coming of this research is that it fails to explore other ways in which health care services can be improved. While the statistics are compelling and analytical, they tend to lean towards the impact of the Medicaid expansion to the government. The program is still in its early stages with few states having implemented it. The effectiveness of the Medicaid expansion program is yet to be proved.
Discussion
Most states are already feeling overburdened by funding the health care sector with most of these states spending up to 20% of their budget on the Medicaid health program. Other sectors such as education receive only 8% of the government funding . Since the law was passed in 2014, only 6 states have decided to implement the Medicaid expansion program. These states have experienced various barriers in the implementation of the Medicaid expansion program. Some of these barriers include the failure of the program to accomplish coverage and accessibility as some of these new candidates live in extremely harsh conditions which limit their ability to gain access to health care services. Most of these individuals suffer from behavioral diseases such as drug and substance abuse which calls for specialized health care services. Diseases such as diabetes are taking a large amount of the resources in the society with some of these individual living below low poverty levels and cannot afford health insurance. Diseases such as diabetes can however be minimized through awareness programs which will educate people on the healthy lifestyles. Medicaid expansion has increased the number of individuals who have access to health care services. Citizens have a right to Affordable health care services but the Universal healthcare which is proposed by the ACA and the Medicaid expansion program is impractical. While the American people are in need of affordable health care services, offering it for free contradicts the American dream. The American people are entrepreneurial individuals who believe in entrepreneurship and self-realization. The Medicaid expansion program is supposed to assist those living below poverty levels to gain better access to health care services. This approach abandons the root cause which is poverty. By increasing funding to other sectors such as education, poverty levels will improve granting the American citizens better access to health care services.
Conclusion
In conclusion, the government has no moral obligation to comply with the Medicaid expansion program. The Medicaid expansion program is misleading and a temporary solution to the problem which is unaffordable health care services. Poverty is the reason why most people cannot afford health care services, making it the key issue in the society. Programs such as healthy living and educating the youth on entrepreneurial skills will ensure that most citizens will be in a position to cater for their health care services without over-burdening the government.
References
Brown, D. S., & McBride, T. D. (2015). Impact of the Affordable Care Act on Access to Care for US Adults With Diabetes, 2011–2012. National Center for Biotechnology Information.
Rosenbaum, S., & Westmoreland, T. M. (2012). The Supreme Court’s Surprising Decision On The Medicaid Expansion: How Will The Federal Government And States Proceed? Health Affairs , 1663-1672.
Sommers, B. D., Arntson, E., Kenney, G. M., & Epstein, A. M. (2013). Lessons from Early Medicaid Expansions under Health Reform: Interview with Medicaid Officials . Medicare & Medicaid Research Review, E1-E19.
