The impact of health care reform on Medicaid and Medicare

By

ACKNOWLEDGEMENT

I would take this opportunity to thank my research supervisor, family and friends for their support and guidance without which this research would not have been possible.

DECLARATION

I [type your full first names and surname here], declare that the contents of this dissertation/thesis represent my own unaided work, and that the dissertation/thesis has not previously been submitted for the academic examination towards any qualification. Furthermore, it represents my own opinions and not necessarily those of the University.

Signed __________________ Date _________________

ABSTRACT

Medicaid program and Medicare program are the two most important healthcare facilities that the Federal government of USA is providing to their citizens. In Medicare, the government is providing healthcare insurance coverage to elderly people and people with some disabilities in the country. In Medicaid, the government is providing medical help to people from the low-income groups of the society. Through a healthcare reform, the Obama administration had attempted to make further improvements in the healthcare system of the country and include even more people in the circle of healthcare. The aim of the healthcare reform was to facilitate even more people in the country and bring them under government protection. However, there are some positive effects, as well as, some negative effects of this healthcare reform.

TABLE OF CONTENTS

ACKNOWLEDGEMENTII

DECLARATIONIII

ABSTRACTIV

LIST OF TABLESVII

CHAPTER 1: INTRODUCTION1

1.1 Context of the Problem1

1.2 Purpose of the study2

1. 3 Significance of the Study2

1.4 Research questions5

1.5 Assumptions and limitations6

CHAPTER 2: LITERATURE REVIEW7

2.1 The history of American health care system7

2.2 The Medicaid program8

2.3 Medicare program9

2.4 Social Welfare Development10

2.5 Barriers to Healthcare Access10

CHAPTER 3: METHODOLOGY12

3.1 Philosophy13

3.2 Research design13

3.3 Justification of secondary research method14

3.4 Criteria for searching literature15

3.5 Keywords15

3.6 Critical Appraisal tool15

3.7 Ethical Considerations15

CHAPTER 4: DATA ANALYSIS17

4.1 The impact of healthcare reform on Medicaid program17

4.1.1 Current State of Medicaid program18

4.1.2 Impact of healthcare reform on Access form Patient20

4.1.3 The Threat to different states21

4.2 Impact of healthcare reform on Medicare program22

4.2.1 Problems with Medicare program healthcare reform22

4.2.2 Benefits of healthcare reforms for Medicare program23

CHAPTER 5: SUMMARY, CONCLUSIONS AND RECOMMENDATIONS25

5.1 Recommendations25

5.2 Conclusions26

REFERENCES28

APPENDICES30

APPENDIX A30

APPENDIX B31

APPENDIX C32

APPENDIX D33

LIST OF TABLES

FIGURE 1: HISTORICAL CLAIMS/UNCOMPENSATED CARE EXPENDITURES (IN MILLIONS) 1996-2000.3

FIGURE 2: ESTIMATED ENROLMENT IN MEDICAID PROGRAM19

FIGURE 3: NUMBER OF ER VISITS20

FIGURE 4: ESTIMATED MEDICAID PROGRAM EMERGENCY ROOM VISITS NET EMERGENCY ROOM (ER) COSTS UNDER PPACA22

FIGURE 1: HISTORICAL CLAIMS/UNCOMPENSATED CARE EXPENDITURES (IN MILLIONS) 1996-200030

FIGURE 2: ESTIMATED ENROLMENT IN MEDICAID PROGRAM31

FIGURE 3: NUMBER OF ER VISITS32

FIGURE 4: ESTIMATED MEDICAID PROGRAM EMERGENCY ROOM VISITS NET EMERGENCY ROOM (ER) COSTS UNDER PPACA33

CHAPTER 1: INTRODUCTION

1.1 Context of the Problem

In the United States system for financing healthcare is a complicated relationship between public and private insurance programs. Financing for healthcare is derived from several sources; i.e. the government, employer benefit packages, charities, and out of pocket for co-payments, deductibles, and uncovered procedures and services. Medicaid program is the government-sponsored entitlement public program that was designed to provide insurance for individuals and families who have low incomes. Both the states and the federal government jointly fund the program.

Medicaid program eligibility is tested, and each ...