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Healthcare Finance Model: Medicaid Program
Introduction
The Medicaid program was created to expand health insurance coverage for low-income people. That is, the target group of the financing model is people whose income does not allow them to purchase more common insurance. Medicaid is funded by both the federal government and the states. Since each state has its own Medicaid program, this poses significant challenges to public administration and creating a general healthcare system. Despite the differences, it remains common that, in order to use Medicaid services, it is necessary to prove that the persons financial situation is below a certain level. By purchasing Medicaid insurance, a person can access inpatient and outpatient treatment, specialist consultations, stays in nursing homes, laboratory diagnostics, and x-ray methods (Medicaid, 2023). Medicaid plays a huge role in building start-up opportunities for different categories of the population and redistributing income in the country.
History of Medicaid
Former President Obamas significant contribution to the advancement of universal health care led to the passage of the Affordable Care Act. It has enabled access to health services for people who cannot afford health insurance even through their jobs or are not old enough to qualify for Medicare (Medicaid, 2023). As the healthcare system changes, a new funding model has emerged, and the Medicaid program for the poor has been expanded, making more Americans eligible for healthcare. That was a big step forward and allowed to make insurance more affordable, but it only solved some of the problems. Any state today can get much federal money to expand the Medicaid program to make it available to everyone living below the poverty line.
Advantages of the Model
As a result of the adoption of Medicaid, those who qualify for funding have access to various extensive benefits. While model provisions vary from state to state, federal regulations require all states to provide a minimum benefit package, and many other healthcare services (Medicaid, 2023). The main advantage of Medicaid is that this program aims at those who live below financial well-being and cannot afford other insurance for various reasons. For example, Medicaid targets both the elderly and people with various types of disabilities.
Those who qualify for the program will receive low and thus more affordable medical costs. Typically, they can be as low as $2, and there are even some procedures that require no co-payment at all (Medicaid, 2023). Medicaid provides financial protection because many medical expenses are covered by this program. It means that those who have a lower income and eventually have to, for example, go to the hospital for a major procedure will not only be able to do so but also not at the high cost of treatment.
Disadvantages of Universal Accessibility
While Medicaid is designed to serve low-income individuals, the model still has eligibility criteria. As a result, not all low-income individuals are eligible for health care, even under the Medicaid model. As mentioned earlier, each state has its own set of specific guidelines for eligibility (Medicaid, 2023). Thus, under the Medicaid program, a large number of people will still not be able to receive the necessary treatment.
Influence
Despite its shortcomings, the Medicaid funding model has significantly impacted the overall availability of health care. In 2018, Medicaid provided health services to 97 million low-income citizens (Policy Basics, 2020). The majority of children, 32 million, and adults from low-income working families, 38 million, were covered by the program (Policy Basics, 2020). As a result, people with low income, who cannot afford expensive insurance, have access to basic and specialized healthcare through this program.
References
Medicaid: Keep America healthy. Medicaid. (2023). Web.
Policy basics: Introduction to Medicaid. Center on Budget and Policy Priorities. (2020). Web.
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