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English 1103 1 Malcom Campbell Zna Le Grand November 6, 2013

The Poors Medicaid, the Governments Rule Originally created to serve the poorest and sickest among us, the Medicaid program has grown dramatically but still doesn't include the kind of flexibility that states need to provide better health care for the poor and disadvantaged. Fred Upton The Medicaid program is a means-tested program for health and medical serviced purposes. It is specifically designed for individuals and families who suffer from low income, as well as those who do not have as many inclusionary resources. The Medicaid program is primarily managed through federal levels, however each state establishes its own eligibility standards; determines the type, amount, duration, and scope of services; sets the rate of payment for services; and administers its own Medicaid program. (Medicalnewstoday.com, What is Medicaid?) In spite of the fact that the States are capable of making decisions on how their Medicaid plans are distributed. There are still federal levels that exist, involving compulsory requirements that have to be met by States so that they will be eligible to receive matching and yet equal federal funds. These services incorporate both impatient and outpatient hospitals, prenatal care, physician services, family planning and the list continues. Apart from the services that are provided from the federal levels, the main inquiry question is how beneficial is the Medicaid program and should it be expanded or not? On health care reform, the American people are too often offered two extremes -government-run health care with higher taxes or letting the insurance companies operate without rules. President Barack Obama and Vice President Joe Biden believe both of these extremes are wrong, which is why theyve proposed a plan that strengthens employer coverage, makes insurance companies accountable and ensures patient choice of doctor and care without government interference (Change.Gov, The Obama-Biden Plan). This statement is a reliable

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example of how the healthcare system in general causes Americans the trouble of paying higher/more taxes due to the government and also endure unruly methods used by insurance companies. Before the year of 2007 insurance companies were capable of denying people because of their genes, specifically those who have pre-existing conditions which may consist of Diabetes, Asthma, Cancer, and Heart Disease conditions that involves essential and consistent checkups. This limits how much or what kind of health services that Americans or people in general can receive. The expansion of the Medicaid Program just as every other part of the healthcare system has advantages and disadvantages. Examining agreements and disagreements from todays society, some people agree to the expansion of the Medicaid program with assertions that fall along the lines of broader benefits for those who are currently suffering from low income. This program provides low-income workers with job security and health coverage for themselves and their families The federal government has long allowed many states to let lapse basic healthcare for the poor, even as states handed out billions in unnecessary corporate tax breaks. Meanwhile, the middle class picks up the cost of providing care to the uninsured through taxes given to hospitals for uncompensated care and higher insurance costs, stated by Scott Randolph, a Democratic Florida state representative. Understanding the existing problems that not only link to and effect the poor, but they also leave effects on the middle class causing them out-of-pocket pay as well. Unfortunately there are a numerous amount of health care contributors who often are not deliberative about the approximate costs before making orders for treatments and tests, provoking patients to pay for exceptionally high and costly bills. General patients are prone to

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believe that the best healthcare is the most expensive healthcare, regardless of their current income. So therefore they are either unaware of these costs or are aware of the cost and feel as if they have no choice but to pay healthcare services to the extreme. However according to Randolph, since he is a Democratic representative for the state of Florida, he deliberately uses Florida to support his assertion. As he states, So currently, uninsured care costs Floridians at least $5 billion per yearnot including what hospitals just write off. Providing coverage to 1.3 million working poor in Florida will cost $2.2 billion. In other words, expanding Medicaid to Florida's working poor will not cause taxes to increase. Rather, it will cut other tax costs while also lowering the price of insurance. Therefore, Florida can afford to provide for its citizens and corporations. Over the last decade, Florida's Republican-led state government has authorized more than $14 billion in corporate tax breaks that now costs the state roughly $4 billion a year. If Randolph is worried about how poor people's healthcare will impact the state budget, he should focus on helping create good-paying jobs for Floridians and raising the minimum wagesteps that will surely reduce the cost of Medicaid (Randolph). Although this state is able to provide for its citizens and corporations, having the ability to create jobs will make even better developments for the state by reducing prices, increasing wages, increase of needed supplies (goods that can be traded), and more workers can be directly hired. With hopes that these created jobs wont just be limited for this state only, and will be liable enough to spread to other states. Or at least other states should consider these steps, even if they may be challenging, if itll help the economy there should be attempts and accomplishments, optimistically. Relevant to Randolphs optimistic outlook, Maggie Mahar, the editor of Healthbeatblog and the author of

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Money-Driven Medicine: The Real Reason Health Care Costs So Much, also agrees with the expansion of the Medicaid program. Arguing that the expansion of Medicaid will not only create jobs but will also extend care. With delineate support, By expanding Medicaid, the Affordable Care Act sets out to cover some 17 million uninsured Americans. Many in this group are adults who currently don't qualify for the program because they don't have children. In most states single adults and childless couples are not considered among "the worthy poor," no matter how little they earn (Mahar). Nevertheless there are people who form the question Can the states really afford such an enormous expansion of this program? (Mahar). However Mahar feels as if this particular question should be asked in a different form, How can they not afford to expand Medicaid? (Mahar). With indications that as an alternative the dollars that are considered for Medicaid use will only create jobs, only if states validate Washingtons offer. Beginning in 2014, Washington will cover nearly 100 percent of the cost for three years, 90 percent after 2020. Washington now picks up just 57 percent of the tab for existing Medicaid patients. Therefore, as long as low-income patients are able to gain access to proper healthcare, hiring will be a needy process for several services. Hiring will be a necessity for several healthcare services in particular because the more healthcare providers equal the more healthcare and treatment for all levels of income that people in todays society receive. Now on behalf of those who disagree with the expansion of the Medicaid Program, their assertions sounds more like this one from Grace-Marie Turner, President of the Galen Institute (which has a focus for market-based policy solutions toward the health reform). Further, the Medicaid expansion will harm the poorest and most vulnerable patients already on the program

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as they are forced to compete with millions of new patients seeking care from this limited pool of providers (Turner). As turner continues she states that Many governors are rightly resisting adding another 16 million more people to Medicaid and are demanding that Washington give them more flexibility to improve the program (Turner). Implying that it is leading to a breaking point in terms of States funding for education, transportation, and public safety with the entitlement of Medicaid consuming a fairly large portion of shared revenues. Due to this breaking point there are governors who are skeptical about adding 16 million more Medicaid recipients, at least until the Medicaid Program is dramatically improved. With further notice that, Even with the generous match rates the health overhaul law offers, the Medicaid expansion would cost them at least $118 billion through 2023, according to a 2011 congressional report by Utah Republican Sen. Orrin Hatch and Michigan Republican Rep. Fred Upton (Turner). According to history money has been a destructive obstacle for the American healthcare system. However there has recently been an attempt to lower these risks, President Barack Obama proposed reducing federal Medicaid spending by $100 billion over 10 years during last year's "super committee" budget negotiations. He proposed changing the traditional federal Medicaid matching rate in a way that would lead to a smaller overall federal contribution to the program and a larger state-based one (Turner). Due to this proposal, this would mean that the states have a pathway to make more self-made decisions versus having the federal government input. Although they will always be a part of the topic of the Medicaid Program, overall itll give states more of an opportunity to decide and stand for what they feel should be appropriate on behalf of Medicaid. Most people disagree with this proposal because they feel as if by allowing states to

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freely conclude decisions that heavily lean towards the Medicaid Program, that itll just make situations more demanding. Directly relating to the assertion of Rick Scott, Republican governor of the state of Florida, Medicaid expansion is bad for states because it would put a tremendous strain on state budgets and increase dependency on government programs. We don't need to expand a big-government program to provide for everyone's needs. What we need is to shrink the cost of healthcare and expand opportunities for people to get a job so more people can afford it (Turner). And since the federal government is not mandated to stabilizing its budget, in order to expand the Medicaid program, it would take higher taxes and or more cuts from state budgets that stand in other areas. These other areas would include detriments to education, transportation, and public safety, which will negatively affect more than just Medicaid. I must say that both the pros and cons of expanding the Medicaid Program, have brought a numerous amount of aspects to my attention. These aspects each bring varying reasons to the table, that either state an agreement or disagreement with the inquiry to expand or to not expand. However I personally agree with the act of expanding the Medicaid program, disregarding the cons and disagreements because they are capable of being contradicted. For an example if the states were to be fully relied upon themselves, there would have to be budget cuts, higher tax rates, and an increased dependency on the government, right? Only to an extent, because overall if the states were capable of identifying and calculating how much is spent throughout their local healthcare services specifically Medicaid wise. They should eventually be knowledgeable enough to strive to the creation of jobs. Mainly jobs that are relative to the fields of health, education, and transportation, because these three topics are considered to be the most effective

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and significant towards societys issues today. Therefore if jobs are created in these specific fields, the act of receiving the best healthcare possible, will be guaranteed and easily accessed due to more advantaged opportunities.

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Work Cited Garber, Kent. What Is (and Isn't) in the Healthcare Bill. USNews.com. U.S. News & World Report, 22 Mar. 2010. Web. 01 Oct. 2013. Mahar, Maggie. Medicaid Expansion Will Create Jobs While Extending. USNews.com. U.S. News & World Report, 24 Jul. 2012. Web. 01 Oct. 2013. Randolph, Scott. Giving Healthcare to the Poor Lowers Health Costs for Everyone. USNews.com. U.S. News & World Report, 24 Jul. 2012. Web. 01 Oct. 2013. Scott, Rick. Medicaid Expansion Would Strain State Budgets. USNews.com. U.S. News & World Report, 24 Jul. 2012 Web. 01 Oct. 2013 The Obama-Biden Plan. Change.gov. The Office of the President - Elect, n.d. Web. 01 Oct. 2013 Turner, Grace-Marie. Medicaid Patients Deserve the Dignity of Private Insurance. USNews.com. U.S. News & World Report, 24 Jul. 2012. Web. 01 Oct. 2013. Upton, Fred. Time to save Medicaid. WashingtonTimes.com. The Washington Times, 7 Feb. 2013. Web. 01 Oct. 2013. What Is Medicare / Medicaid?" MedicalNewsToday.com. MediLexicon International, n.d. Web. 01 Oct. 2013.