Today is a huge day for the Health Care Reform law and President Obama. The US Supreme Court has issued a stamp of approval for the Affordable Care Act. While this ruling does pave the way of US health care for all, it also assures most Americans higher premiums. The exception to this would be the low income and people who are Medicaid eligible. Medicaid is expected to double in size so many of the non contributing Americans will get picked up by Medicaid.
Health Care Reform – Who pays for Medicaid?
While the government does pay for Medicaid, the bigger problem is that Medicaid does not pay appropriate amounts to hospitals and doctors. Many doctors can avoid taking Medicaid, but hospitals don’t have it so easy.
For example, Forth of July will be a busy day for emergency rooms. Let’s assume the ER gets a visit from three similar accidental injuries, and one person has Medicaid, one person has private health insurance, and the last person is an illegal immigrant with no insurance and no medicaid. We’ll pretend each person has a broken ankle and simple fracture. During the visit they each see two doctors and each get x-rays, cast, crutches, and some pain medication.
First and foremost they would all get the same treatment, hospitals have to take people as they come in and they cannot refuse any one person. What becomes interesting is how the entity must pay. With Medicaid their is a set list of medical codes and what Medicaid will pay. The amount that Medicaid pays is FAR LESS then what the private health insurance company will pay.
In some cases the private health insurance company may pay 2-4 times the amount that Medicaid will pay. Meanwhile, the illegal immigrant may pay some money, but many just take the treatment and never pay the hospital anything. If they are here illegally it is difficult for the hospital to send the bill to collections and take proper action to get paid for the services provided.
So with this very simple example, let’s say that Medicaid pays out $400, the private health company pays out $1200, and the illegal immigrant does provide $100 cash to the hospital. Once all the dust settles, and hospital pays its many costs for doctors, equipment, facilities, nurses, utilities, administration costs, attorneys, and malpractice insurance, then the hospital is left with an overall cost of doing business and providing treatment. In this example the cost is probably well below the $1200 which the private health insurance company contributes and certainly higher than what Medicaid would provide. Needless to say, the private health insurance companies subsidize the other entities.
Follow this link to read the full text document of Health Care Reform ruling.
Where are we today with Health Care Reform?
Health Care Reform is here to stay. By January 1st 2014 Americans will be expected to have health insurance or to pay a tax to the IRS. As stated before Medicaid will double in size. If Medicaid is not pulling it’s own weight, then private health insurance companies will have to pick up the slack. For most states this means health premiums will rise, drastically. However, some states such as New York, New Jersey, and Massachusetts should not see much change in premium. A young healthy family of four in New Jersey spends around $950 – $1100 a month to have insurance. Meanwhile, the same family health insurance in California could get the same exact coverage for around $500 a month.
Health Care Reform is not all doom and gloom.
All-in-all Health Care Reform is a good thing. Our US health system needs an overhaul. Most American’s realize this. However, most American’s also realize that we are a country of obesity. America has 78 million people who are not heavy or a little chunky, but clinically diagnoses as obese. We are also a country consumed with opiate pain medication and anti depressants. The amount of narcotics legally prescribed in our country is absurd. Most states consume anywhere between 50,000 – 100,000 tons of prescribed narcotic per a year. On the news when you see our soldiers in Afghanistan, you see the miles of amber poppy fields….
It is unfortunate that the Affordable Care Act is not the Accountable Care Act. Only through accountability can our country control its health care costs. Secure your low health insurance quotes today by locking in your policy rates for one year.