New Health Care Reform and Medicaid

The Health Care Reform Act that was recently approved and signed into law has been very controversial.

While everyone has an opinion on whether the bill was good or bad, there are some changes that will affect the Medicaid and Medicare programs.

We have outlined parts of the bill that will make changes to both Medicaid and Medicare.

1. By 2014, Medicaid coverage will be expanded to everyone under the age of 65 that are below 133% of the Federal Poverty Level (FPL), also known as the poverty guidelines. This will remove the current Medicaid eligiblity criteria which leaves many individuals that are currently in poverty to go uninsured.

2. Increase Medicaid reimbursements to 100% of Medicare for primary care providers for 2013 and 2014.

3. Under the Medicaid drug rebate program equalize treatment of fee-for-service and managed care.

4. Create state-based health exchanges where individuals can purchase coverage, with premium and cost-sharing credits are available to individuals and families with incomes between 133% and 400% of the poverty guideline.

5. Provide an individual mandate to make sure that all Americans participate in the insurance risk pool which should result in lower insurance cost coverage for everyone.

This also requires that insurers provide coverage to those with pre-exisiting conditions, removes lifetime limits, prevention services must be covered at 100%, and prohibits removing someone from coverage.

6. The Medicare Advantage Special Needs program was reauthorized.

7. By 2020, the Medicare prescription drug "doughnut hole" will be closed.

8. Improve the coordination of Medicaid and Medicare dual eligibles.

What do Americans want regarding Medicaid?

According to the Kaiser Family Foundation (KFF) survey released on May 25th, 2011, more than half of Americans surveyed do not want to have Medicaid funding cut and are wary of changing how the federal government funds the Medicaid program.

The KFF survey revealed that 60 percent of the Americans surveyed "prefer to keep Medicaid as it is." This means the federal government would continue to guarantee Medicaid coverage and setting the standards for Medicaid eligibility and benefits.

Thirty percent of Americans favored minor reductions in Medicaid spending and only 13 percent were in support of major Medicaid cuts.

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The official U.S. Government Medicare Web site is cms.gov.