Running Head: Medicaid Expansion

MEDICAID EXPANSION
PRIYANKA GEORGE
PROF. SANDRA HAYES
HSA 540
Jan 23rd 2016

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MEDICAID EXPANSION

State without Medicaid Expansion:

The Florida Senate that had an approval for Medicaid expansion in 2015 was
rejected by Gov. Rick Scott (R) and the state House. There was a shut down over a budget
impasse by the state government but the state lawmakers agreed on a final budget deal without
an expansion. They are still under debate to expand Medicaid again in 2016 (The Advisory
Board Company, 2016).

Being part of the Medicaid program can enhance the countrys

economic impact on the state. It can also impact hospitals. Hospitals already face serious
financial pressures from results of payment cuts, bad debts, and uncompensated care. Medicaid is
designed for low-income uninsured adults and also boost coverage for poor children too.
Non expansion can make the state a less competitive environment for
business. People within a non-expansion state will be less competitive. They must absorb cost
shifting and thus higher premiums from large rates of uninsured.
States opting out of the Medicaid expansion will face the gap in
subsidized coverage for citizens between 0-100% of Federal Poverty Level (FPL). States have to
keep an eye out for what is called the work effect which is prone to happen due to streamlined
Medicaid eligibility and enrollment (Piper, 2012).
Opportunities and Challenges of Medicaid Expansion:
The object of Affordable Care Act (ACA) was to increase access to health
insurance to the low-income, poor and children population. The consequences though of opting
out of the Medicaid expansion will have adverse health and financial consequences. There will
be people who will not have the access and there will be results of drastic health conditions. This

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will result in depression, catastrophic medical expenses and death (Dickman, Himmelstein,
2014). Expansion of Medicaid services will only increase the demand for medical services and
give the public the opportunity to pay for basic medical services. With more people covered
under Medicaid, it would save money for everyone who provides or pays for uncompensated
care.
States that do not expand Medicaid miss an opportunity for economic growth which results in
missed opportunities for new jobs (Mahan; Callow, 2014). Medicaid funding is a huge support to
jobs and enhances generation of income within all healthcare sectors. The economic impact of
Medicaid spending is intensified by the infusion of new dollars from the government that
otherwise is not existent in the state (Bazelon Center, 2012).
Approaches to Expanding Access to Care:
To fill in the coverage gaps and make up for the lost revenue are now pursuing
alternative approaches to cover more low-income population. States that do not have any medical
expansion forgo millions in federal spending (Garber; Collins, 2014).
State support of safety net clinics would make the difference
between expansion and closure. The safety net makes possible the implementation of Medicaid.
This safety net serves immigrants, uninsured, the working class. State and federal involvement in
providing community care gives great hopes and promise for improving basic health access. Our
current system, in which each employee faces the same amount of health care costs in order to
get the full insurance is similar to a head tax. It is regressive in the sense that lower-paid workers
must pay a larger percentage of their incomes than higher-paid workers (Christopher, Robertson,
Keith, 2015).
Using a no missed opportunities approach will focus on bringing people the best

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care, in the best way. Some states are involved in a public-private partnership to repay loans for
primary care physicians and nurse practitioners working at community health centers (The
Commonwealth Fund, 2010). Some of the few other approaches would be

Designing payments that will contribute enough revenue for sustainable health coverage
for a population;

Employing payment design to promote appropriate and efficient use of health care; and

Using health coverage and payments to contribute to broader social and political policies

These approaches will result in comprehensive coverage expansions. Health insurance premiums
and out-of-pocket spending for health care are a large component of family budgets and a burden
to a growing proportion of working Americans (Rowland 2007; Banthin and Bernard, 2006).
State Legislature and Medicaid:
The main objective of the legislature is to expand health insurance and make it
accessible to millions of people who do not have the access nor the resources. Affordable Care
Act (ACA) supporters are content that the States have been given authority to decide whether to
expand Medicaid programs (Antos, 2014). Medicaid expansion efforts are being endorsed by
chambers of commerce and other business groups promoting a legislative agenda for the next
governor (Willard, 2015). Medicaid expansion will help reduce racial, geographic, and ethnic
disparities. Absence of Medicaid expansion will result in only legal immigrants and not citizens
will receive the benefits of ACA coverage below 100 percent of federal poverty.
Going back to Florida, the State House republican was against Medicaid expansion not knowing
what a difference it would make to the people in need of it.

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References

Antos, J. (2014). Medicaid expansion under the ACA: Dollars and sense? Retrieved on April 10
from https://www.aei.org
Banthin, J. and Bernard, D. (2006). Changes in Financial Burdens for Health Care: National
Estimates for the Population Younger than 65 years, 1996 to 2003, JAMA 13(296):
December 2006: 2712-2719.
Bazelon Center (2012). New Opportunities to Expand Medicaid Under the Affordable Care Act.
Retrieved in July from http://www.bazelon.org
Chrsitopher, T., Robertson, A., Keith, A. (2015). Scaling and Splitting: new approaches to
health insurance. Retrieved from http://object.cato.org/sites/cato.org
Dickman, S., Himmelstein, D., McCormick, D., Woolhandler, S.(2014). Opting Out Of
Medicaid Expansion: The Health And Financial Impacts. Retrieved on January 30
from http://healthaffairs.org
Garber, T., Collins, S. (2014). The Affordable Care Act's Medicaid Expansion:
Alternative State Approaches. Retrieved on March 28 from
http://www.commonwealth0066und.org
Mahan, D., Callow, A.(2014). Expanding Medicaid: Better Health, Jobs, and Economic Activity
for States. Retrieved from http://familiesusa.org

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Piper, K. (2012). Medicaid Eligibility Expansion: Arguments For and Against States Opting for
ACA Medicaid Expansion. Retrieved on September 10 from http://piperreport.com
Rowland, D. (2007). Health Care: Squeezing the Middle Class with More Costs and Less
Coverage, Testimony before the U.S. House of Representatives Ways and means
Committee, January 31, 2007
The Advisory Board Company (2016). Where the states stand on Medicaid Expansion. General
Format. Retrieved on January 13 from https://www.advisory.com
The Commonwealth Fund, (2010). States in Action Archive. General Format. Retrieved on
March 18 from http://www.commonwealthfund.org
Willard, P. (2015). What Three State Elections Could Mean for Medicaid Expansion. Retrieved
on October 22 from http://familiesusa.org