Part 1
In California State, there are many controversies surrounding the healthcare coverage for migrant individuals, who are not documented. Such revelations come in the wake of the concerns facing the contributions that these migrants make to the economy of the state. These immigrants make up almost a tenth of the state’s labor force contributing over 2 billion dollars in terms of the country’s revenues (Graves, 2015). This situation is worsened by the fact that the current healthcare legislations in place act as barriers to these groups of Californians in accessing the crucial service. The healthcare legislations under the Affordable Care Act in terms of the Medicaid and the Covered Care prohibit the unemployed migrants from accessing the care and only recognize individuals who are employed (Graves, 2015). The implications that such a situation is going to have on the state will be mainly on health care matters For instance, the fact that these individuals cannot be able to access healthcare exposes the rest of the community in danger in the sense that their chances of contracting communicable diseases also increase. Secondly, since these individuals are active contributors to the local and state economy, it will translate to the production levels deteriorating since the number of days these individuals will be at work is not sufficient.
The policy ramifications coming from this issue are based on the fact that it is only noncitizens that are affected by it. Persons coming into the nation find it challenging getting the required healthcare since their entry into the country is not well documented. As such, these persons are usually viewed as illegal migrants whose motives might not be well known (Graves, 2015). This translates to laxity in having them registered and included in the healthcare schemes of the state.
There have been however attempts that have been put in place by the senator and the president in making sure that these individuals are in a better position to have access to the required care.
The key stakeholders involved in the development of the legislations are mainly interest groups and the legislators. The legislator mandated with ensuring that the law is passed through the senate is Senator Ricardo Lara. He introduced a bill to the senate that will see the undocumented low-income earners access medical healthcare by enrolling in the Medicaid program (Graves, 2015). Interest groups will play the role of lobbying for the required funding to be provided so that such persons are able to have insurance coverage.
The persons who will be responsible for implementing this policy issue will be the state and federal government, the senator, the healthcare providers and the affected individuals. The federal and the state government will be tasked with availing the required funding to ensure that the program is rolled out. The senator who is the custodian of the bill will be tasked with providing the function of oversight in making sure that the policy issue is actually being done as planned. Healthcare providers like physicians and nurses will be tasked with providing the actual medical care to restore these individuals to their original states of health (Graves, 2015). The role that the migrants play in the policy formation is also important since they are the ones who are supposed to register for these covers.
The federal state is also involved in the development of the policy issue in the sense that the president has signed into law regulations that allow undocumented individuals to apply for the country’s citizenship which will make it possible for them to live and work in the country without necessarily having the fears of being deported. Such a development has made it easy for these migrants to be able to apply for the state-funded Medicaid system for most individuals who are not documented. Such efforts are seen as a move by the federal state in ensuring that this California citizenry is able to have access to the required healthcare that they require (Graves, 2015). State and federal officials are also in consultations that will oversee the federal government being able to waive the fees related to the provision of healthcare. This move is aimed at addressing the health care needs of undocumented migrants who have got acute and chronic illnesses.
Part 2
The Medicaid health care program bases its strengths on providing care to individuals who are not well off financially without discrimination and whose federal poverty levels meet the required standards set to receive the cover. The fact that some families may be having low-income levels thereby qualifying them for the Medicaid cover makes it also possible for other individuals whose financial capabilities may be slightly higher but still do not meet the minimum wage; but may want to take insurance covers which they deem the most appropriate for their children (The Center for Children & Families, 2015). As such, parents who take CHIP covers for their children aim at reduced bureaucracies usually involved with the Medicaid system.
The similarities between these two modes of healthcare cover are that both of them are public insurance programs which are tasked with providing insurance covers to children. Both of them are jointly funded by local and federal governments programs. Lastly, these two healthcare systems provide healthcare covers for children who have got special health care needs up to the tune of 35% of the entire charges (Sugawara, 2014). The differences between these two covers are that the Medicaid system covers children from the age of 6 years to 19 years whereas the CHIP system covers children aged 0 to 19 years (The Center for Children & Families, 2015). The parents that have taken the CHIP cover for their children may have to co-pay for the services that they need to be given to their children which are a totally different case in the Medicaid system. The CHIP program in the state of California is referred to as the California Healthcare Eligibility, Enrollment and Retention System (CalHEERS) (Sugawara, 2014). Individuals who are covered by this health care program include children from 0 years to age 19 and pregnant women. For children to be eligible for this plan, the federal poverty levels of their families are supposed to be capped at above 200%. The pregnant women covered by this plan must have a federal poverty level that is capped at 185%. The main reason why there are so many uninsured children and families mainly dwells on the fact that the required information concerning the available healthcare insurance covers dies not reach them (The Center for Children & Families, 2015). This reason makes it a challenge accessing this valuable service that plays a significant role in the well-being of such individuals.
Part 3
It is worth noting that the VA system is different from the Medicaid and the Medicare healthcare systems basing on the fact that these systems provide care to specific members of the society. The VA system, for instance, is in charge of taking care of former members of the forces and who are now retirees. On the contrary, the Medicaid and the Medicare systems cover the general members of the society (Center Forward Health Basics, 2012). Even though the two systems provide care to individuals who have got disabilities in the society, the difference comes in the sense that that the disability talked about in the VA system is the one gotten when the veterans time in service. The Medicaid and Medicare systems address general disabilities. The other difference between these two covers is that; while the Medicaid and Medicare system provide insurance covers, the VA system dwells on offering direct medicinal services instead of insurance covers (Center Forward Health Basics, 2012). The similarity between the two systems is that both of them provide healthcare services to the population with the objectives of restoring their health back to normal.
The lesson that the Medicare and the Medicaid can learn from the VA system is the efficiency in which the services are offered. The long bureaucratic processes followed in these two systems need to be checked which will result to better patient outcomes (Congressional Budget Office, 2014). Additionally, there is the need for the Medicaid and the Medicare systems to borrow a leaf from the VA system since in the latter system; care provision is done at any hospital whereas, in the former case, healthcare is only provided at designated health care settings. Closing these disparities have got the effect of checking on the overall costs involved and also resulting in desirable patient care outcomes (Congressional Budget Office, 2014).
References
Center Forward Health Basics. (2012). Medicare, Medicaid, and the Military: Government-Provided Health Care. Retrieved from http://www.center-forward.org/wp-content/uploads/2012/04/Medicare-Medicaid-and-the-Military-04-12-update-2.pdf
Congressional Budget Office. (2014). Comparing the Costs of the Veterans’ Health Care System With Private-Sector Costs. Retrieved from https://www.cbo.gov/sites/default/files/113th-congress-2013-2014/reports/49763-VA_Healthcare_Costs.pdf
Graves, S. (2015). Issues to Watch in 2015: Expanding Health Care Coverage to Undocumented Immigrants in California - California Budget & Policy Center. Retrieved from http://calbudgetcenter.org/blog/issues-to-watch-in-2015-expanding-health-care-coverage-to-undocumented-immigrants-in-california/
Sugawara, R. (2014). Medicaid and CHIP Eligibility Review Pilot – Round 1. Retrieved from http://www.aphsa.org/content/dam/NAPIPM/PDF%20DOC/2014%20Conference/PERM%20Pilot%20California%20-%20Robert%20Sugawars%20(CA).pdf
The Center for Children & Families. (2015). About CHIP - Center For Children and Families. Retrieved from http://ccf.georgetown.edu/chip/about-chip/
