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Response To Health Care Policy

Response To Health Care Policy

Sharon Turner RE: Discussion – Week 9COLLAPSE

Medicaid and Medicare were created in 1965 as a way to help care for the elderly (CMS.gov, 2018).

It started off in two parts, Part A covered hospital insurance and Part B covered medical insurance

(CMS.gov). Eventually, Medicare expanded to cover other groups of people outside of the elderly.

This group included the disabled, and people with end-stage renal disease (CMS.gov). Medicaid

also extended to cover low-income families, pregnant women, people with disabilities of all ages people

with long-term care (CMS.gov).

A specific Medicaid policy that should be amended in the state of New York is Medicaid Buy-In

Program for people with disabilities.  This program is designed to offer health insurance to people who

Suffer from disabilities that cannot afford health insurance because of their income

(NYS Department of Health). They make too much to qualify for Medicaid and not enough to buy

into a plan with their employer.  To qualify, they must be a resident of NYS, be at least 16 years old,

have a disability as defined by Social Security Administration have gainful income (full time or part-time),

and income that is not to exceed $61, 740. The cost that the client would have to pay into the buy-in

the program is income based.  Although this program is designed to help cover the cost of health

care expenses, I would suggest that to reduce the income enrollment eligibility requirements. People

who have disabilities may have additional expenses is not covered by health insurance such as adding

a wheelchair ramp to their home.  So, by paying into the Medicaid By-in Program, they have to

cover the cost of the premium, in addition to taking care of their family (if they have one) and

any outside costs for their disability.

Stakeholders are people in the community, physicians, clinicians, law-makers, and community agencies.

The purpose of stakeholders is to evaluate policies and procedures, measure development, provide

feedback to developers, implement rule making process and help formulate what is in the best interest of the

community.

Cassandra Diggs RE: Discussion – Week 9COLLAPSE

HAffordable health care services have not always been provided to low income, elderly, or disabled adults. The evolution of health care policy led to the creation of Medicaid and Medicare. Medicaid and Medicare were a part of President Lyndon B. Johnson’s social reform movement to eliminate poverty and racial injustice (Koba, 2011). President Johnson signed amendments to the Social Security Act on July 30, 1965, establishing Medicaid and Medicare and providing former President Harry Truman and his wife as the first recipients of Medicare (Koba, 2011) As health care has continued to progress and programs were created, such as, Medicaid and Medicare, more people are able to receive medical attention.

“In the state of Louisiana, Medicaid provides health and long term care to approximately 1.7 million low-income children, pregnant women, adults, seniors, and people with disabilities in the state of Louisiana for the year of 2018” (Heidelberg, Llorens, & Richardson, 2018). A Medicaid policy that I would like to see amended is the Louisiana Children Health Insurance Program. While this expansion of Medicaid does extend to children, the state of Louisiana continues to work to define the age of a child and extend it beyond 18, as more youth are in foster care and continue to be lost after aging out of the system. Like Medicaid, this program has several stipulations and aside from age, family members may not have an income more than 217 percent of the federal poverty level (Louisiana Department of Health). While it is important to monitor programs such as Medicaid and Medicare and set forth guidelines, children and families that are not meeting the guidelines may still benefit from receiving assistance from such programs. If I had an opportunity to amend the policy, I would permit children within families to continue receiving the assistance until the age of 20 and/or employment is secured. Allowing the age to be extended assists with tackling issues experienced in the state of Louisiana, such as:  homelessness, suicide, and violence.

The stakeholders that assist with the Medicaid and Medicare policy in the state of Louisiana consists of the people, providers, Louisiana Department of Health, Department of Child and Family Services, Office of Juvenile Justice and Department of Education, and Magellan of Louisiana. Insurance companies, patients, providers, organizations, and health care systems are all affected by changes that are created to policies and must advocate for the needs of individuals that are being served. In regard to the Louisiana CHIP policy, stakeholders would be responsible for providing research on children and the outcome of success and continuing with health care after 18. After research has been completed, it is pertinent that issues are relayed to communities where advocacy can then take place.

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