Policy Brief: Healthcare Reforms in Vermont - Essay Example

Policy Brief: Healthcare Reforms in Vermont Policy Brief: Healthcare Reforms in Vermont It should be d that different s in the United States had different ways to their reform agenda. Nonetheless, the healthcare reforms in Vermont are highly positive that it can serve as roadmap to other states (Feder, Rowland, and Salganicoff, 1993). Vermont’s health care system is quite progressive and this is noted to be contributed by the fact that they never wait for initiation of the implementation steps defined by the affordable care act (United States Government Accountability Office, 2011). In other words, Vermont usually votes for its own state based reform systems. Notably, the affordable care act requires states to establish their independent insurance exchanges. In other words, they want states to default to the federal exchange. Nonetheless, it should be noted that the joint federal state programs were initiated to fund the medical services in the United States. This is a long term project that was initiated to provide care to the moderate income families. Moreover, it is worth noting that Medicaid is among the largest federal funded budgets and it has had a rapidly growing cost, but with unsustainable rates (Rosen, 1988). The huge cost of this program to the federal government’s budget calls substantial overhaul towards reducing the taxpayers from huge funding burden. Nearly all states including Vermont usually receive Medicaid with an open ended funding from the federal government (Kaiser Commission Medicaid, 2012). The expansion of the state budget along with their expanded benefits usually leaves the taxpayers with no option but to pay additional costs. It should be noted that the current funding structure provides a room for overexpansion that in turn provides the states with limited incentive to control extensive waste and fraud programs. Moreover, program is designed in a top down regulatory structure thereby creating distortions within the health care markets. However, the Medicaid intra governmental grants have proven to be effective and efficient for the funding mechanisms within the United States funding systems. Notably, they have created conditions that match the states’ funding considerably. In essence, the program allows the federal government to share specific expenditures that are attached to the program. These programs attached to the Medicaid services are known as the federal medical assistance percentage (FMAP). The FMAP was initiated for the government to have a larger percentage in the Medicaid costs in states. However, the highly targeted states are those with low incomes (United States Government Accountability Office, 2011). It worth noting that the federal government in line with Medicaid funding initiated a formula to determine what states need its funding on the Medicaid programs than others. This formula offers a minimum of 50 percent funding and it has never changed since its initiation and adoption alongside the Medicaid program. However, during the great recession, in the year, 2008, the formula changed slightly since there was need to increase funding to the deeply affected states by the recession. In other words, the 2008 changes on the FMAP led to slight increase on the Medicaid funds. This was applied to many states, but this essay is interested on such effects on the state of Vermont. In the material year, 2008, Vermont spent $952,261,374.87 on its Medicaid program compared to its $904,331,790 spending on the same program on the year 2007. This is an indication that its Medicaid funding increased with 5.3 percent increased funding from the federal budget for the Vermont state due to recession. Unlike other states, the increased in funding on the Medicaid program was very low. This translated to $542,316,861 extra compared to the previous year. This made each enrollee to have $172,842 this figure is as per the FMAP (United States Government Accountability Office, 2011). Notably, the figure is above the national average of $5,842. This high value may be pegged on the high income of the state. This value in high enough to suggest that Vermont medical system largely benefit the people of Vermont and nearly all of them are treated with highly value medical care systems to which they benefit across the state. FMAP Floor Change It should be noted that Vermont may no longer be among the states to be considered for the federal government as per requirement of the FMAP program defined within the Medicaid system. The state of Vermont has shown internal development towards funding most of its programs. Down through the 2009 recession and 2011, the Vermont state government has enacted numerous functional laws including its first state level law of single payer health care systems (Kathleen, n.d.). The H.202 passage established the green mountain care system where every Vermonter is entailed to universal health care covers. Moreover, the Vermont’s single payer health care systems improved the technological systems that already exist within its health care system (United States Government Accountability Office, 2011). This program started in 2010 after the end of the second recession and it included the Act 128 provisions. However, if the state of Vermont makes changes within it health care systems by adopting 30 or 60 percent then the same will affect its FMAP. Notably, the change will lead to reduced or no benefit from federal government Medicaid aids. This is because funding the state on the program will make the program to lose it goals and objects. The program is intended to fund state with low per capital but such improvement will improve or rise Vermont’s per capita thereby making it defined or fall within the state that can sustain their own health care systems without the help of the federal government. This change is an advantage to the Vermont states since it will be self-sustained and it will be making it health care policies without depending on the grants from the central government. Additionally, it should be noted that the Difference from ARRA Unemployment Adjustment in the state of Vermont is -0.70 and the Simulated Increase in FMAP Based on Changes in Unemployment Rate is 1.28. This is a clear indication that this state is moving from self-sustainability and will depend on the federal government on decimal grants (Kaiser Commission Medicaid, 2012). However, for the future recessions (if they will occur), the state of Vermont should move to GAO prototype formula. This formula will offer the budgeting personnel of the state with a timely and precise option to assist its Medicaid during such national economic downturns. Nonetheless, with the current application of the FMAP floor, the Vermont congress should consider all elements of the FMAP formula in order to evade situations that may not reflect the economic reality of the state (United States Government Accountability Office, 2011). For instance, other than the employment, the state must consider infrastructure development of the state among other factors including education of its citizens. References Feder, J. M., Rowland, D., & Salganicoff, A. (1993). Medicaid financing crisis: Balancing responsibilities, priorities, and dollars. Washington, DC: AAAS Press. Kaiser Commission Medicaid. (2012). Financing: An Overview of the Federal Medicaid Matching Rate (FMAP). Retrieved March 30, 2014, from http://www.academia-research.com/filecache/instr/m/e/1045247_medicaid-fmap_1_1_.pdf Kathleen, A. E. (n.d.). Equity in the Medicaid program: Changes in the latter 1980s. Health Care Financing Review, Spring95, Vol. 16, Issue 3. Retrieved March 30, 2014, from http://www.academia-research.com/filecache/instr/e/q/1045247_equity_in_the_medicaid_program_adams95.pdf Rosen, H. S. (1988). Fiscal Federalism: Quantitative Studies. Chicago: University of Chicago Press. United States Government Accountability Office. (2011). MEDICAID Prototype Formula Would Provide Automatic, Targeted Assistance to States during Economic Downturns. Retrieved March 30, 2014, from http://www.academia-research.com/filecache/instr/g/a/1045247_gao_report.pdf Read More