Medicaid is a federally and state funded program that allows people
that are living below the poverty line to qualify for health insurance.
While each state sets it guidelines for eligibility, thirty-eight states
and the District of Columbia allow those that are 138% below the
poverty level, the remaining states allow for “Medicaid Coverage
Gap” for those who are above the threshold (Nowicki, 2022).
Medicaid is the single largest payer of healthcare and not without
issues, with over $600 billion spent annually, there are improvements
to be made for vulnerable populations to receive quality care.
(Melillo, 2021). An issue with Medicaid is that the guidelines vary
state to state and leads to inaccuracy in quality metrics as well the
programs efficiency. Varying guidelines also cause problems within
the program as eligibility is determined by income. This program
serves those who typically are also at risk for financial instability
therefore, it may not always provide stable coverage (Melillo, 2021).
The benefits to having to having 75 million Americans (Melillo, 2021)
with access to health insurance is that research has shown that due to
a decrease of those that are uninsured, there are more patients with
breast, colon, and lung cancers that have been discovered in the early
stages and no evidence in delay in treatment (Takvorian, et al., 2020).
Not only has the expansion of Medicaid decreased the number of
uninsured and early-stage cancer detection, but it has also shown a
reduction in Metabolic disease, reduced the likelihood of issues with
gross motor skills, and activities of daily living (McInerney, et al.,
2020)
Michael Nowicki. (2022). Introduction to the Financial Management
of Healthcare Organizations, Eighth Edition: Vol. Eighth edition.
Gateway to Healthcare Management.
Melillo, G. (2021). Experts Outline Medicaid Challenges, Potential
Reforms. AJMC, 19.
Takvorian SU, Oganisian A, Mamtani R, et al. (2020). Association of
Medicaid Expansion Under the Affordable Care Act with Insurance
Status, Cancer Stage, and Timely Treatment Among Patients With
Breast, Colon, and Lung Cancer. JAMA Netw Open.;3(2): e1921653.
doi:10.1001/jamanetworkopen.2019.21653
McInerney, M., Winecoff, R., Ayyagari, P., Simon, K., & Bundorf, M. K.
(2020). ACA Medicaid Expansion Associated with Increased Medicaid
Participation and Improved Health Among Near-Elderly: Evidence
From the Health and Retirement Study. Inquiry : a journal of medical
care organization, provision, and financing, 57, 46958020935229.
https://doi.org/10.1177/0046958020935229
