State Medicaid policy choices (including the ACA coverage expansion, other eligibility levels, scope of benefits, reimbursement rates and delivery system models) as well as other factors such as demographics, health needs, health care markets, and state fiscal capacity affect Medicaid spending.
Will states that expand Medicaid save money?
Not every state that expands Medicaid will experience large savings in their traditional Medicaid programs, but many will. Not every state will experience large savings outside Medicaid, nor revenue growth, but some will.
What are the different types of Medicaid benefits?
Some states offer additional benefits, such as prescription drug coverage, physical therapy, respiratory care services, podiatry services, optometry, dental services, hospice and other home and community-based services. Federal law requires states to provide Medicaid assistance to the following groups:
What are the economic benefits of Medicaid?
Medicaid produces economic benefits for both the individuals it covers and society as a whole. Medicaid is responsive to economic downturns, enabling people to access coverage and care in times of financial stress.
What is the fiscal impact of Medicaid expansion on States?
Studies that examine the fiscal impact of Medicaid expansion on specific states or the effects across all states find consistent results: expansion leads to significant budget savings and significant revenue increases (even without imposing additional taxes).
How does the basic structure of the Medicaid program lead to major challenges for state programs during an economic recession?
Medicaid is a countercyclical program. During economic downturns, individuals lose jobs, incomes decline and more people qualify and enroll in Medicaid which increases program spending at the same time as state revenues decline, making it difficult for states to match rising expenditures.
What are two things covered by Medicaid in most states?
Medicaid covers a broad range of services to address the diverse needs of the populations it serves (Figure 5). In addition to covering the services required by federal Medicaid law, many states elect to cover optional services such as prescription drugs, physical therapy, eyeglasses, and dental care.
What does Medicaid do for states?
The Medicaid program is jointly funded by the federal government and states. The federal government pays states for a specified percentage of program expenditures, called the Federal Medical Assistance Percentage (FMAP).
What are the pros and cons of Medicaid expansion?
List of Medicaid Expansion ProsNot every low-income individual actually qualifies for Medicaid. ... Expansion would support local economies. ... It offers people a level of financial protection. ... Medicaid expansion drops the uninsured rate. ... The cost of expansion is minimal for the states.More items...•
What are the disadvantages of Medicaid?
Disadvantages of Medicaid They will have a decreased financial ability to opt for elective treatments, and they may not be able to pay for top brand drugs or other medical aids. Another financial concern is that medical practices cannot charge a fee when Medicaid patients miss appointments.
What are Medicaid requirements?
Who Is Eligible for Medicaid?children through age 18 in families with income below 138 percent of the federal poverty line ($29,974 for a family of three in 2020);people who are pregnant and have income below 138 percent of the poverty line;certain parents or caretakers with very low income; and.More items...•
What can states do to contain Medicaid costs?
Despite this improved prognosis, several factors continue to place pressure on states to contain Medicaid costs. The cost-containment strategies states have adopted include reducing provider payments, reducing prescription drug costs and targeting fraud and abuse.
Why have Medicaid expenditures increased and what can states do to contain Medicaid costs?
In general terms, Medicaid expenditure increases can be caused by: (1) cost increases for current enrollees resulting from changes in health care prices or health care utilization, (2) cost increases caused by enrollment growth, and (3) increases in "other" costs, such as those for DSH or UPL payments or administrative ...
Is Medicare state or federal?
federalMedicare is the federal health insurance program for: People who are 65 or older. Certain younger people with disabilities. People with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD)
Can the federal government force states to expand Medicaid?
In 2012, the Supreme Court of the United States ruled that the federal government could not force states to expand Medicaid under the ACA. That's because it would cost money for states to cover more people under Medicaid. As a result, each state could choose whether or not to expand their Medicaid program.
Was Obama care a good thing?
The Affordable Care Act has both increased the number of insured Americans and improved the coverage offered by health insurance companies. Millions of previously uninsured Americans have been able to obtain health insurance because of the ACA.
What are the cons of Medicare?
Cons of Medicare AdvantageRestrictive plans can limit covered services and medical providers.May have higher copays, deductibles and other out-of-pocket costs.Beneficiaries required to pay the Part B deductible.Costs of health care are not always apparent up front.Type of plan availability varies by region.More items...•