Medicaid in New York

Medicaid in New York
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Medicaid in New York
All Americans have the fundamental human right to obtain high-quality, affordable healthcare. Despite family earnings, the United States is a developed nation with effective, high-quality healthcare services supporting equity for all citizens. The Affordable Care Act's changes have improved health insurance coverage nationwide. The nation implemented Medicaid, a public health program offering health insurance to low-income earners and those with physical disabilities, to provide equal health care. Other states, including New York, have implemented Medicaid programs. The program's primary goal is to give low-income households and physically impaired people access to healthcare, but it has had many problems, including a financial shortfall. The study reviews New York's Medicaid program focusing on the population group eligible for the program and how it is affected by the healthcare delivery system. It also proposes new changes to the program while analyzing the effects this change could have on the healthcare delivery system.
Medicaid in NY and Population Group Accessing the Program
Medicaid offers low-income individuals and children free health care. It can provide up to 90 days of retroactive reimbursement for outstanding medical expenses if a person requests this insurance and is qualified for it within those ninety days. Over seven million New Yorkers with modest incomes have access to adequate health coverage under the Medicaid program (New York State, 2023). Based on an individual's age, financial status, family-related situation, or living situation, Medicaid may cover a variety of treatments. A person can get these treatments directly with their Medicaid card or through a managed care program if they are enrolled in managed care via a sizable network of medical providers. Small co-pays for certain services could apply; however, these can be excused if someone cannot afford them.
Medicaid is an insurance scheme for low-income people with resources and earnings below a specified threshold. Children, expectant mothers, singles, families, people with disabilities, and those who are certified blind or physically impaired are among the categories who qualify. Additionally, even if a person has resources and income higher than the Medicaid income limits but still has medical debt, they may still be entitled to Medicaid. Medicaid resource and income thresholds typically shift on January 1 of every year (Buettgens et al., 2021). Only those legally blind, legally disabled, or older than 65 must take a resource test. If a household or child is not qualified for Medicaid, they may be qualified for Child Health Plus or Family Health Plus.
Nearly 57 percent of those enrolled in Medicaid are adults between 18 and 64, and 43.5 percent are minors. Regarding Medicaid registrations, New York City accounts for around 53 percent, Long Island for about 10.8 percent, and the remaining 36.2 percent comes from various counties across the State (New York State, 2023). Due to the MAGI population moving from 20 additional upstate counties to the NY State of Health in 2021, more participants in 2021 than in 2020 are from counties outside New York City. NY State of Health's membership in Medicaid is diversified. About 27% of those who registered, according to the New York State of Health, identify as white, 11% as African American, 2% as Chinese, 6% as Asian Indian or other Asian, and 3% as belonging to any other ethnicity (Joyce, 2021). Roughly 47 percent of people who enroll do not declare their race. 81.5 percent of enrolled people do not specify their ethnicity (Feke, 2020). Only 17% identify as Hispanic. The NY State of Health has concluded that 3.8 million people are Medicaid-eligible as of October 2022.
Medicaid and its Effects on Health Care Delivery System
Medicaid enhanced reported health and improved access to and usage of healthcare. One year after the program launch, the adults who received Medicaid had a 69.5% higher likelihood of having a routine place of care and a 59% higher likelihood of having a regular doctor (Centers for Medicare & Medicaid, n.d.). According to Ko & Glied (2021), Medicaid also boosted the use of preventative care like mammography (by 55.5%) and cholesterol screenings (by 25%), and Medicaid individuals had more visits to hospitals, hospitalizations, and prescribed drug use. These trends were all linked to better primary care.
Medicaid significantly enhanced adults' mental well-being, but its effects on physical health remain unclear. Several years following its operations, empirical clinical data on both groups of adults revealed that, compared to not having insurance, Medicaid resulted in a 29.5% decrease in the proportion of positive depression screenings (Feke, 2020). Improvements in physical wellness were less substantial: Medicaid failed to have a statistically significant impact on managing high blood pressure, high cholesterol, or diabetes despite Medicaid increasing the diagnosis of diabetes and the administration of diabetes medications.
Additionally, Medicaid virtually removed catastrophic medical costs. Medicaid also decreased the probability of having healthcare debt by more than 25%. Catastrophic personal spending, defined as expenses representing more than 31% of income, decreased substantially among those now covered by Medicaid (Chin et al., 2020). Additionally, Medicaid had a major effect on all self-reported indicators of financial stress brought on by healthcare expenses, like obtaining credit or ignoring other obligations to cover medical expenses and being denied care because of healthcare expenses in the previous six months.
Achievement of the New York's Medicaid Program
In New York, the Medicaid scheme has enrolled around 24% of the population. According to statistics, the initiative in New York has reached one in six adults, one in four children, six out of every ten disabled people, and six out of all nursing facility residents (Joyce, 2021). Beneficiaries of the initiative enjoyed affordable routine medical examinations, vaccinations, and lab tests. The least expensive but most potent medication choice is offered to any Medicaid subscriber by NYS physicians via the Medicaid formulary. As a result, the scheme has helped New York State achieve its goal of providing its citizens with inexpensive health care.
Additionally, the initiative has made it possible for qualified New York citizens and low...