In the State of The Union, President Obama touted that 9 million Americans had received insurance through the Affordable Care Act (ACA). Of these 9 million Americans, 3 million enrolled in private insurance plans and 6 million enrolled in Medicaid. But these numbers and their forecasted impact on health care delivery are misleading.
First of all- the 3 million enrollees the President claimed to have enrolled in private plans is deceptive. Only 70of these 3 million people have actually paid for their plans. This would be comparable to Amazon counting every item a customer places in their shopping cart prior to checking out as a sale. Furthermore, of those 70who have successfully paid for their plan, 66already had insurance and were forced to purchase a new plan when their coverage was suddenly dropped due to the ACA. .
However, Medicaid is a low-income individuals. It provides some coveragebut it is not a health plan Americans should be excited to have. Medicaid expansion a means to improving access to quality health care for millions of Americans. The Oregon Health Insurance Exchange study, the first randomized controlled study analyzing Medicaid outcomes, recently concluded, “Medicaid coverage generates no significant improvements in measured physical-health outcomes.” Other studies show that, in some cases, Medicaid patients actually wait longer and receive worse care than the uninsured. At best Medicaid recipients can expect outcomes equal to or worse than what others not on Medicaid would receive.
Medicaid an important social safety net. The program was designed to protect the most vulnerable citizens in American society. However, expanding eligibility to working adults ( earning 400above the poverty line) only resources that should becaring for the most vulnerable. A recent concluded, “expanded Medicaid eligibility … will, reduce incentives to work.” The resident talks a lot about inequality. Working has the ability to increase one’s social mobility. The ACA and its Medicaid expansion programs would essentially increase inequality. Medicaid only provides benefits to individuals at the very bottom of the income ladder. This program is not for everyone and expansion may exasperate its existing problems.
Medicaid has significantly lower reimbursement rates than private insurance and Medicare. On average, Medicaid reimburses doctors 72 cents each dollar theyspend on treatpatients. In 2008, New York’s Medicaid reimbursement rate was 29 cents per every dollar spent. An analysis published in Health Affairs found that only 69 percent of physicians accept Medicaid .Medicaid makes it increasingly difficult for doctors remain profitable. Increasing the number of Americans enrolled in Medicaid force more doctors to reject the insurance.A study in the New England Journal of Medicine found that Medicaid recipients six times more likely to be denied an appointment than individuals with private insurance. According to another study, Medicaid patients wait an average of 42 days to see a doctormore than twice as long as the privately insured. A University of Virginia study found that surgical patients on Medicaid have a 97 percent higher chance of in-hospital death than patients with private insurance, and a surprisingly 13 percent greater chance of in-hospital death than those with no insurance at all.
Medicaid expansion is not the way to improve access to quality health care. Medicaid expansion could actually reduce the quality of care for millions of Americans previously enrolled in private insurance plans. These Americans lose their more expensive, but higher quality insurance plans when their state chooses to expand its Medicaid program.
It is important to remember that Medicaid is a state program monitored by CMS. Not all state Medicaid programs are equal. Some provide better outcomes than others. However, on the whole Medicaid costs taxpayers $450 billion a year and offers on average suboptimal outcome for the millions of Americans forced into it. The fact that the Obama Administration is adding millions of Americans to the Medicaid programs should not be touted as an accomplishment ather a travesty of justice.
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