Medicaid Expansion

Expansion of Medicaid
Affordable Care Act was put in place by President Obama in 2010 providing Americans access to affordable health insurance. But, our gov. Nikki Haley, the Republican Party are still rejecting the Medicaid expansion for the state of South Carolina. My paper has detailed information on why governor Haley and Republicans made their decision to opt out of the expansion. Also, alternate approaches to expanding access to care and implement or consider the state’s decision of opting out of the expansion. Two contrast approaches for comparison will be provided initiative for Medicaid expansion. Finally, recommend to the state legislature to convey opting out of Medicaid expansion.
South Carolina without Medicaid Expansion
In

the state of South Carolina, Governor Nikki Haley opposes the Medicaid expansion, and the majority of Republican’s rejected the Medicaid expansion. Governor Nikki Haley opposes the Medicaid expansion (SCMA, 2012). In 2014 Governor Haley opposed the Medicaid expansion, but 500,000 million was added to the Medicaid program. Medicaid program expectative a total of 1.085 billion state dollars in 2020 Medicaid program. In the state of South Carolina, the government will “inject $13.34 billion to the economy and it is 92.75 to 7.5 that will match the federal” (SCMA, 2012).
The Medicaid program has impacted our hospital and the economy of the state of South Carolina. There are a lot of pressures for most of the hospitals in the state dealing with bad credit, pay cuts, and financial pressure. According to U.S. News (2012), "the Supreme Court upheld the President Patient Protection and Affordable Care Act because it was the big key to a health care law expansion of Medicaid." This program is based on lower-income individuals and children that are below poverty level. But, the state refused to this program which might result in a big risk of losing federal funding for this program.
The state opting out of the expansion is the ruling from the Supreme Court decision to not punish the state by expanding the Medical expansion. South Carolina has a larger population of Medicaid use and the state opting out of the drive for the budget deficit.

Opportunities and Challenges of Medicaid Expansion
Comparison to the fourteen states that opting out the estimate of 3.6 million people are insured, but the states spent 8.4 million on uncompensated care affects all states for their decision not to proceed with joining in the Medicaid expansion. The Affordable Care Act provided those who are eligible if their annual income is below the poverty level at 138 percent (Price and Eibner, 2016). Anyone with a higher percentage of 100 incomes will not be eligible for the Medicaid program. But, without the Medicaid expansion, there will be a lack of access to health insurance that is affordable.
According to South Carolina Hospital Associations (2012), President Obama signed the Patient Protection and Affordable Care Act into law March 2010.

There were changes made by the United States federal government make significant changes to the health care system. The expansion of Medicaid was more so for; lower-income, poor and children’s population. The reason for South Carolina to opt out of the Medicaid expansion because it will affect employers, a taxpayer, and the health industry due to increasing of federal funding that represents unambiguous benefits to South Carolina (SCHA, 2012). One of the challenges are increasing funding for the spending of new sources on the outside may not exist for South Carolina. The outside spending is a big economic component for growth, export, manufacturing, and national firm. Therefore, due to the increasing federal funding, South Carolina made the decision to opt out of Medicaid expansion (SCHA, 2012). This will increase federal funding in South Carolina choice to opt into Medicaid expansion to provide jobs and more income is the effect of the decision

made.
Approaches to expanding Access to Care
South Carolina opt out of the Medicaid expansion, but instead allocated 80 million in funding the budget for the state and federal through an incentive program in the hospitals (Advisory Board, 2016).

The state opting out for certain provisions of Affordable Care Act that include a requirement of minimum coverage, employer contribution and coverage for a dependent adult up to insurance age of 26. According to the National Conference of State Legislatures (2016), “The Affordable Care Act provides a variety of optional state funding grants to pay for or implementation of specific provisions of the ACA.”
The House Republicans passed Obama alternative budget for the Medicaid expansion for the state budget. This plan is put in place to help bring health care cost down in the form of government expenditure (SC Policy Council, 2013). These principals measure means:
1) The state will pay low-income hospital 35 million for non-emergency needs from ER and funded clinics
2) It will pay 10 million to the clinic for consequent

cost
3) It will pay 20 million for rural hospital at a 100 percent coverage cost of uncompensated care for low-income patients
It will also pay for student loans for doctors who have taken jobs in underprivileged communities and to the initiative to expand other programs. The big initiative is proposal involvement in recurring expense. But, the biggest initiative is that health care cost is essential to the Affordable Care Act is some of the changes to be made to lower health care cost and the benefit of the long or short term for low-income patients. The new federal health care is a problem which is in the trillion to the nation debt, and taxes is raised to 699 billion this is why the increase of insurance premium.
State legislature Recommendation on Medicaid Expansion
South Carolina objective for recommendation is whether or not to opting out of the Medicaid expansion is the portion of spending from the federal revenue. The objective for the legislature is to expand health coverage insurance and make it accessible for millions of Americans to health care. Governor Nikki Haley decision not to expand Medicaid expansion, it will hurt millions of Americans health needs. This Medicaid participation decision on moving into or out of each state comparing the flow of federal fund tax dollars (Glied & Ma, 2013). The Affordable Care Act has increased access to health insurance by;
1) Requiring the states to expand Medicaid eligibility for those with less income by 138 percent poverty level with cost expansion which will be paid by the federal government.
2) Establish online insurance exchanges with more benefit structure for those to compare different insurance plans
3) Requiring uninsured individuals 138 percent above federal poverty level without facing penalties providing premium up to 400 percent federal poverty level
In 2012 the Supreme Court ruled that South Carolina opting out of Medicaid expansion in 2013 (Dickman, Himmelstein, McCormick & Woolhandler, 2014). This decision will leave millions of uninsured individuals without Medicaid coverage, but the finical or health impact have not reached quantification status. It would help reduce racial, ethnic disparities if Medicaid expansion if the federal government was not opting out. Therefore, without Medicaid expansion, it will result in legal immigrants and those who are not a citizen to receive these benefits of Affordable Care Act at a 100 percent of federal poverty. South Carolina republican’s decision against expanding Medicaid expansion not knowing how it would affect those who really need a better health opportunity.
Conclusion
There is a provision in which Medicaid expansion can play for lower-income people in the states where it is needed. Medicaid expansion will increase access and increase cost cause for tax-payers. Through the establishment of medical insurances exchanges, Medicaid expansion can work to improve on coverage and access to health care. This access to health care will be able to provide cost saving for the states and the federal government. Medicaid expansion for the lower-income people that are below the poverty level will access to prevent any diseases or any death due to health choices. The poor choices that can harm you, smoking, lack of exercise, and diets. But, in order for people to have access should have affordable health care coverage, quality of care, and affordable health insurance.