Module 04 Course Project - Healthcare Reform in Two States

Running head: MEDICAID PROGRAM FOR MIDDLE CLASS 1

MEDICAID PROGRAM FOR MIDDLE CLASS 2

Medicaid Program for Middle Class

Tia Branden

Rasmussen College

03.05.21

Medicaid Program for Middle Class

Part I

Introduction

Medicaid is a national program that seeks to offer medical support for all Americans. Newborns and the elderly benefit from Medicaid regardless of their social status (inferior, middle class, or other groups of people). Statistics prove that one adult is insured through Medicaid, and one child is guaranteed in every three in the whole country out of five Americans. People are offered an opportunity to go for check-ups, and their stay in the hospital, whether short-term or long-term, is paid for. Medical practitioners and hospitals are also beneficiaries of Medicaid through funds and other subsidies. In general, the burden of healthcare services for low-income earners and hospitals is reduced significantly (Ehealth, 2021). This has strengthened healthcare systems in the country and helped boost the economy. Affordable Care Act (ACA) is a program through Medicaid that has significantly helped middle-class families in America access healthcare services. This is an opportunity for individuals who cannot obtain or do not want employer-based insurance coverage for healthcare services. This essay will discuss the program's purpose and its effectiveness in executing its objectives in ensuring that the people who are part of it are benefitting.

The purpose of the Affordable Care Act (ACA) in healthcare services

Federal Poverty Line (EPL) helps individuals to understand where their income stands. This is very important for middle-class individuals who want to purchase medical insurance coverage through the Affordable Care Act (ACA). (Thomas, 2017). An individual is eligible for specific programs and benefits that the Affordable Care Act (ACA) provides if the Health and Human Services department gives information to EPL who use it for that purpose. The Affordable Care Act (ACA) benefit is that it ensures its members for medical services and offers them access to save through marketplace health insurance. Also, the Children Health Insurance Program (CHIP) is covered under this program. Some subsidies give members a premium coverage plan for their selected marketplace insurance.

Affordable Care Act (ACA) offers a tax credit for individuals whose income is between 2

100% and 400%. Health insurance premiums are also paid for those who may struggle to acquire medical insurance. People under ACA are protected from increasing premiums since the subsidies decrease or decrease proportionately, like the premiums.

How the subsidy for the middle class works: ACA subsidies are two. Advanced Premium Credits, which is applied, mainly helps individuals to pay for insurance premiums acquired in a year. The qualified members can take a tax credit that their health insurer can use to offset annual premium coverage. Still, the individual can pay monthly premiums, and the tax credit will be issued once the tax return is filed. If household income is overestimated or underestimated, a marketplace application can be updated online to avoid adjustments when filing tax income returns. Another subsidy under the Affordable Care Act (ACA) is Cost-Sharing Reduction. This subsidy is for eligible members. It helps lower out-of-pocket expenses. This is done for covered services through payment of the deductible or copayments.

Who qualifies for the Affordable Care Act (ACA) subsidy? This program helps individuals that cannot pay for health insurance. They are the people who cannot afford employer or government-sponsored medical covers (Lanford & Quadagno, 2021). To be an eligible member, one has to have an income that can predict. Furthermore, the size of your household or location can also affect a person’s qualification. For example, people in Hawaii should check the US department of health.

Is Affordable Care Act (ACA) program effective?

Many people who are middle class in the United States of America can access medical coverage that they can afford on the marketplace. Affordable Care Act (ACA) had proved to be effective when a crisis like the COVID-19 pandemic struck the economy affecting income primarily of middle-class persons. Household persons who qualify start from one with an estimated poverty line of $12,760 and up to eight members with an estimated poverty line of $44,120. The EPL provides this income information. Affordable Care Act (ACA) has an estimated membership of 10.7 million in the whole country. 87$ of this population that purchased the marketplace insurance cover obtained premium subsidies the year 2020, according to the report by the Centers for Medicaid. This information reveals that the middle class resolved to get the insurance that will enable them to obtain healthcare services when economic activities were affected drastically (Thomas, 2017). The covid-19 pandemic affected the middle class in terms of their incomes and businesses due to governments' measures to compact its spread.

Moreover, suppose a person loses a job, accompanied by the losing employer sponsoring your health insurance Affordable Care Act (ACA). In that case, it ensures that you can afford healthcare services through its subsidies (Grogan & Park, 2017). It covers college-aged children who can't qualify for student insurance. Individuals who suffer from sicknesses that are likely to make them hospitalized frequently are also covered. These are just some of the highlights that make the Affordable Care Act (ACA) program effective for middle-class individuals and households in the US.

Benefits of the ACA program: Those enrolled in ACA-subsidized or non-subsidized plans have a chance to select family or personal cover for themselves or any other person within the family who does not have healthcare insurance they can afford (Chattopadhyay, 2018). Additionally, the Affordable Care Act (ACA) offers flexibility in deciding which plan will work for you. Premium subsidies can be used to reduce the burden at any level of the plan purchased on marketplace insurance cover. If you lose your job, spouse (through divorce or death), and the relocation of the Affordable Care Act (ACA) will still offer you services. But if you get a job or decide to terminate your plan. This can be done within the year if you acquire another insurance cover like employer-based insurance.

Other viewpoints toward the ACA program.

Being assigned a level for premium subsidies makes it unaffordable for households with higher incomes and more than three members (Grave & Swartz, 2017). The levels are bronze, silver, and gold. Affordable Care Act (ACA) has large subsidies, and some members may acquire free bronze or gold plans that are more expensive than silver methods. Since employers are likely to offer health insurance to their employees, ACA members may not be able to afford or qualify for ACA plans significantly when the cover is extended to family members. This makes it difficult to afford medical cover for the plan that suits your family member (child or spouse) either from employers or marketplace plan.

Unfortunately for individuals earning above 400%, according to EPL, are illegible and may not comfortably pay for ACA plan to cover healthcare services. This is because they are forced to have an extra earning per year that will enable them to fully pay for medical coverage through the Affordable Care Act (ACA) plan (Brandon, 2021). This implies that those individuals with relatively low incomes cannot access quality healthcare services. This is because quality comes at a price.

Conclusion

Marketplace insurance cover of healthcare service through Affordable Care Act (ACA) plan is adequate for middle-class families who are not covered with employer-sponsored insurance. More families are benefitting, and even low-income families are not left behind. The middle class should check the benefits of joining given medical insurance since the best option will guarantee that one can ensure that they and their loved ones can afford healthcare services. Medicaid helps an individual obtain healthcare facilities through subsidies dependent on the individual’s annual income. This is an opportunity for many people to have access to affordable healthcare.

Part II

GOOD HEALTH INC.

CLIENT’S APPLICATION FORM Date…………………….

Client information

Full name: ………………………………… DOB……………………. Sex…………………….

Marital status……………………………..

Identity card/driver’s license…………………………………………. Home address…………….

Cell…………………. Email………………………………………. Work phone………………..

State……………………. City…………………………

Employer………………………….. Occupation……………………….

Employer’s address……………………………………. City……………………

Emergency contact not living with you………………………………. Contact address…………

Next of kin information

Full name……………………………. Sex……………………… Age…………………..

Cell…………………. Email………………………………………. Work phone………………..

State……………………. City………………………

Emergency contact information

Name……………………. Cell………………………

Department……………………..department’s name………………….

Current workplace……………………….. Relationship………………………….

Insurance information

Insured policy………………………………Insurance company…………………………

Address…………………………….. Policy No ……………………………………….

Primary insurance………………….policy holder’s name………………………..

Address………………………….cell……………………….

Secondary policy…………………………policy holder’s name…………………

Address……………………………cell…………………………

Declaration

I, at this moment, declare that information provided in this form is accurate according to the best of my knowledge and belief. I have not willfully withheld any relevant information to this material fact. I declare to uphold this agreement's requirements, and I shall not witness any form of misconduct.

Name…………………..date…………………………signature……………………

Terms and condition

I have read the terms and conditions of this agreement, and I now declare that I understood what pertains to this commitment.

Name……………date……………………..signature…………………….

References

Brandon, W. P. (2021). Federalize Medicaid to Fix the Affordable Care Act: For Efficiency, Equity, and Social Justice. Journal of Health Care for the Poor and Underserved, 32(1), 68-89.

Chattopadhyay, J. (2018). Is the Affordable Care Act cultivating a cross-class constituency? Income, partisanship, and a proposal for tracing the contingent nature of positive policy feedback effects. Journal of Health Politics, Policy, and Law, 43(1), 19-67.

Ehealth. (2021). ACA health insurance subsidies and the middle class. Retrieved from https://www.ehealthinsurance.com/resources/individual-and-family/aca-health-insurance-subsidies-and-the-middle-class

Graves, J. A., & Swartz, K. (2017). Effects of Affordable Care Act marketplaces and Medicaid eligibility expansion on access to cancer care. Cancer journal (Sudbury, Mass.), 23(3), 168.

Grogan, C. M., & Park, S. (2017). The politics of Medicaid: most Americans are connected to the program, support its expansion, and do not view it as stigmatizing. The Milbank Quarterly, 95(4), 749-782.

Lanford, D., & Quadagno, J. (2021). Identifying the Undeserving Poor: The Effect of Racial, Ethnic, and Anti-Immigrant Sentiment on State Medicaid Eligibility. The Sociological Quarterly, 1-20.

Thomas, D.G. (2017). Middle-class Medicaid. Retrieved from https://www.barrons.com/articles/middle-class-medicaid-1498887732