Articles Tagged with Medicaid

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Today, the United States Senate released its draft legislation designed to “repeal and replace” Obamacare (also known as The Affordable Care Act).  What is most evident in this legislation is the massive destruction of the Medicaid program.  Medicaid is the single largest healthcare program in the United States.  Medicaid serves one in five Americans.  Medicaid covers not only poor individuals, but two-thirds of all nursing home residents.  Many nursing home bills run between $5000 and $7000 a month for skilled nursing care.  The majority of our elderly community cannot self-pay for that level care should it be necessary.  Medicare does not cover long-term skilled nursing care.  So when we talk about cutting Medicaid, we are talking about the future care of ourselves and those we love.

The Senate bill will phase out the Medicaid expansion that is part of Obamacare.   Obamacare provides for 100% federal funding over a three year period and 90% funding after that for those states that expanded their Medicaid programs.  Medicaid is a federal program that is administered by states.  Georgia did not elect to expand Medicaid.   Those states that did expand Medicaid saw a significant decrease in their uninsured populations.  And importantly, sick and indigent individuals had access to medical care.

Today’s proposed legislation proposes “block grants” and per capita spending limits – a draconian solution that has never been part of the Medicaid program.  Currently, Medicaid provides healthcare coverage to individuals qualifying from an income and asset standpoint.  This current legislation caps the amount of money provided to states regardless of the number of eligible recipients.  Hence, coverage will be drastically reduced for those states with significant poor populations.  Georgia ranks 42nd in overall poverty.  https://talkpoverty.org/state-year-report/georgia-2016-report/ is third in the nation for medically uninsured individuals.  http://www.georgiahealthnews.com/2016/09/georgia-ranks-high-rate-uninsured/

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Medicare is a federally funded program that provides medical care to senior citizens 65+ years old. Medicare is also available to disability beneficiaries who receive Disability Insurance Benefits (DIB) through Social Security.  Senior citizens are always guaranteed to be covered, but Medicare isn’t entirely free–patients are often required to pay part of their medical costs. Since Medicare is run by the federal government, coverage is basically the same universally throughout the United States.

Medicaid provides financial assistance to low income individuals of any age, as demonstrated need presents itself. Your income must be below a certain amount in order to receive Medicaid. Patients are sometimes required to pay nothing, but there is sometimes a co-pay. Medicaid is run jointly by both the states and the federal government so rules and regulations vary depending on your state of residence.

It is possible to be on both Medicare and Medicaid, depending on eligibility for both programs.

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Frequently, someone contacts me who is recently disabled due to a traumatic accident and has no access to healthcare. A similar scenario was depicted recently in a New York Times article on healthcare. Oregon resident Wendy Parris shattered her ankle. Because she was uninsured, the emergency room doctors did not operate on it, but rather placed the ankle in an air cast and discharged her. For four years, she hobbled on the broken foot becoming less mobile and gaining weight.

images.jpgIn 2008 Oregon participated in a study where it opened its Medicaid rolls to some working adults living close to the poverty level. Oregon provided healthcare insurance to these uninsured via a lottery system. This allowed Oregon to test a hypothesis on how having healthcare effects individuals and whether having healthcare actually saves money. The study showed that having health insurance made people happier, healthier and more financially stable. The study also dispelled the myth that Medicaid does not help people and that people can get care in ways other than through Medicaid. In fact, the chronically ill or traumatically injured have trouble navigating the healthcare maze of community clinics and charity hospitals. Frequently, they go without care.

Wendy Parris won insurance in the lottery. When she did she was able to have her foot surgically repaired. She was also able to get treatment for her depression, help with her mobility and help losing weight. According to Wendy, “it saved my life.”