Health Care

WELFARE REFORM ACT AND MEDICAID IN UNITED STATES Name: Grade Course: Tutor’s Name: (05, January, 2011) Welfare Reform Act and Medicaid in United States Factors That Determine Medicaid Eligibility There are various factors that are used to determine whether an individual becomes eligible for the Medicaid or and some of the factors include the following: the federal mandates that a beneficiary of the service should be referred to as being categorically needy and this include people who are characterized by low incomes and who posses few resources and it they includes individuals who are the beneficiaries of certain Medicare services with low incomes. The group of people referred as being categorically needy includes pregnant women who have low incomes, families with dependent children who often other receive financial assistance, those who are eligible of receiving supplemental security income (SSI), children and infants who meet the low-income requirements. Conditions for direct billing of Medicaid patient A provider is allowed by the federal law to bill a patient directly for services when the following conditions are met: when a patient has been informed by the physician prior to treatment that the service to be performed is not covered by the Medicaid, when the physician informs the patient in advance on the estimated cost of the procedure and the patient in turn agrees in writing to pay the stated charge and finally the physician must have an established written policy that covers billing of non-covered services not only by the Medicaid service but also that applies to all patients. The simultaneous involvement of the federal and state in the insurance process means that means that individuals can therefore access there insurance benefits across various states making it easy for individuals who might move from one state to another without creating an inconvenience to the system. It also means that individuals can be served in any state hence availability of a ‘universal’ insurance service. The Welfare reform has had both success and failures but it has to a greater extent failed to address the goals it was intended to. The welfare reform has played a unique role by utilizing the payroll taxes from everyone in the country to assist thousands of people who are in need in the society. The welfare system has done a great deal in assisting the elderly, dependent children and the unemployed and hence it has helped the disadvantaged in the society to mange their lives and stand up for themselves. On the other hand for instance, the welfare reform was signed in 1996 with the high expectations that it will limit the number of emigrants who access the Medicaid especial those who immigrated after the year 1996 when the reform was passed, but such expectation and intentions has been dwindled as the welfare reform has done more harm by cutting out emigrants who by the federal laws are eligible to the service as they arrived in the count earlier than the stated year of exclusion. This has resulted to massive discrimination against aliens who otherwise are exempted and legible for the services. This welfare reform has therefore failed to address its initially intended goal of curtailing the offering of Medicaid and other relat...