Medicaids eligibility rules - Essay Example

Medicaids eligibility rules Medicaids eligibility rules In USA getting any type of medical insurance is as a matter offact expensive. For people being unable to get a traditional medical insurance there is another option. Medicaids is a social health care program in USA intended to provide families and individuals with low income and resources with health insurance as they cannot afford paying for health care (Andersen et al., 2013). The program is managed and funded on both state and federal levels, being eligible for people who are US citizens or legal permanent residents, including adults with low income, their children and disabled persons.

Tracing back to the adopted laws, the Medicaid program first provided medical coverage for low-income families and other categorically related individuals who meet eligibility requirements (Andersen et al., 2013). Candidates enrolling to the program included the blind, aged, disabled and pregnant women. In fact, Medicaid serves as the nation’s primary source of health insurance coverage for low-income populations. By the way, each state have always been administering its own Medicaid program, establishing their own eligibility standards, determining the scope and types of services they cover, and setting the rate of payment.

Moreover, benefits vary from state to state (Andersen et al., 2013). Since 2013 due to the expansion of Affordable Care Act, the enrollment to the program has been eligible only for those with low income rate. Thus, states participating in the expanded Medicaid program are required to allow people with income up to 133% of the poverty line to qualify for coverage, including adults without dependent children (Andersen et al., 2013). That is to say the eligibility for the program depends purely on income level.

It is quite doubtful whether managing a program this way and whether the amendments introduced to the law are efficient. In essence, there is a dramatic difference in needs that has a single adult who is paid insufficient, pregnant woman or an elderly or disabled person. For example, after retirement elderly people spend either the rest of life or some time in nursing homes, the cost of which is very expensive. Many people pay for these nursing homes with their own money, often depleting their life savings, and spend thousands on it.

In this case Medicaid should help cut these costs at least. Another case is when an immigrant, who does not have a well-paid job and cannot afford traditional medical insurance, may qualify for Medicaid, due to financial needs. Of course, everybody applying for this type of insurance program should be required to pass an asset and income test to become eligible for the benefits (Sommers & Rossenbaum, 2011). First of all, I think, attention should be paid to medical restrictions (mentally handicapped, physically challenged, etc.) or certain life conditions (pregnancy, small children, low-paid job, etc.) the individual may have, and then, the financial status.

As the letter may suddenly change for worse, considering today’s unstable economic situation, care should be taken of those who in such situation would suffer more than others. Therefore, the government’s paramount task is to distribute the medical coverage means between low-income populations and reconsider the eligibility requirements in order to improve the system of medical care and help the nation be healthier.References Andersen, R. M., Davidson, P. L., & Baumeister, S. E. (2013). Improving access to care.

Changing the US health care system: key issues in health services policy and management, 33.Sommers, B. D., & Rosenbaum, S. (2011). Issues in health reform: how changes in eligibilitymay move millions back and forth between Medicaid and insurance exchanges. Health Affairs, 30(2), 228-236.