Introduction
The excerpt indulges in the repealing for the reinstatement of the Obamacare health program. Obamacare, also referred to as the Affordable Care Act (ACA), was created by Congress and President Barack Obama in 2010 (Teitelbaum & Wilensky, 2020). The principal goal of the program was to ensure that all American citizens had the access to health insurance. The plan aimed at reducing the health care cost, thus, lowering the rising expenses of Medicaid and Medicare. Registration of persons without health coverage was stipulated to be done annually by January 31 through health care exchanges. However, it outlined that the individuals who missed the enrollment were entitled to acquire temporary care and insurance firms were prohibited from negating coverage to people with pre-existing health conditions. This essay aims at highlighting the ACA, as well as creating a discourse about possible contributors to the low rates of Medicaid reimbursement in New York during this coronavirus pandemic period.
ACA and Medicaid Reimbursement Rate during the Coronavirus Era
Obamacare provided free wellbeing and preventive care consultations for elderly persons on Medicare. Other provisions included a 50% tax credit on Obamacare costs for proprietors of small enterprises constituting of the at most 25 employees offering wellness insurance (Teitelbaum & Wilensky, 2020). Larger companies with at least 50 workers are obliged to offer health coverage otherwise they face a $2,000 fine per member of staff (Teitelbaum & Wilensky, 2020). However, the success of the program has been capped by the ruling of the federal judge in December 2018 terming it as unconstitutional. The administration of Donald Trump has also contributed to swindling the implementation of the program through the reduction in the enrolment period, slashing program budgets. Moreover, it facilitated the termination of payments for cost-sharing reduction (CSR) by the US government for insurance firms covering low-income patients in the scheme.
The United States, as well as other countries globally, is suffering from the breakout of the coronavirus (Covid-19) pandemic. There is an expected substantial cost for providing clinical care and services to patients seeking medication against the virus. The epidemiological projections by the Institute for Health Metrics and Evaluation (IHME) predict that inpatient care will have an expenditure of about $24 billion by October 31, 2020 (Glied et al., 2020). However, the disbursements will differ from state depending on the policy decisions of the individual state, demographic distribution, as well as the extent to which the pandemic is spread out. Notably, the elderly and low-earning groups are highly vulnerable to the disease and likely to experience disproportionate impressions. Remarkably, these individuals rely on public insurance coverage due to the lower premium rates, in comparison to the private rates of payments. The hospitals serving these aging and low-paid persons experience an upsurge in Covid-19 cases as opposed to the amenities handling the well-off and younger people.
The impact of the initial wave of the Covid-19 illness was witnessed in New York. The state incurred $2.7 billion inpatient overheads, while other federals expended a much-reduced amount (Glied et al., 2020). However, there has been a drastic decrease in caseloads in New York since the end of May 2020 while other states have been experiencing increment in the number of coronavirus inpatients. The majority of people who seek Covid-19 hospital care are those aged 65 years and older, and are insured by Medicare (Glied et al., 2020). Furthermore, the number of uninsured persons in New York is much smaller compared to Texas and Florida states which failed to diversify Medicaid (Bernstein, 2020). Subsequently, there is a proportionate decrease in the reimbursement rate by the New York State Medicaid.
There has been an escalation in the admission of the younger grown-ups than the elderly ever since May. From all the hospitalizations, the Medicaid patients are expected to be few (Glied et al., 2020). The hospital care will prefer private insurers and self-insured patients since their rates of disbursement are usually relatively higher than the Medicaid amounts. The variations in cost will ultimately form a fundamental basis for the sharing of the epidemic funding. Consequently, the budget allocated to Medicaid will be lesser compared to that compensated for Medicare. There is also a projection that the health facilities may opt for billing care of uncovered clients at list charges as they are six times higher than the Medicare costs (Glied et al., 2020). However, the hospitals should be aware that the reimbursements may end up as uncompensated health care.
Conclusion
The dissemination of the coronavirus reimbursement budgets to hospice care from the different sources of payments varies over time and across federations. It is attributed to the policy discrepancies and the shifting epidemiology of the Covid-19 pandemic. The ultimate cause of the deviation is the diverse amounts contributed by the payers towards the coronavirus patients in the hospital care. The disproportionate effects of the Covid-19 disease have been felt by the low-income earners and the aged populations shielded by the public coverage. Consequently, the health care facilities that offer services to these underprivileged classes of people have been doubly deprived by the compensation rate variants. Indeed, they have encountered escalated healthcare demands, while being paid lesser recompense for the services and care they provide. However, if the ACA had not been subjected to opposition by the critics, it would have been the most effective program in taming the brunt of the coronavirus pandemic.
References
Bernstein, J. (2015). The success of the Affordable Care Act is a hugely inconvenient truth for its opponents. The Washington Post.
Glied, S., Zhu, B., Chakraborty, O., & Tang, A. (2020). Who will pay for COVID-19 hospital care: Looking at payers across states. Commonwealthfund.
Teitelbaum, J., & Wilensky, S. (2020). Essentials of health policy and law (4th ed). Jones & Bartlett Learning.