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1 page/≈550 words
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Health, Medicine, Nursing
English (U.S.)
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Economic Impact of States declining Medicaid Expansion (Essay Sample)


To prepare:
1) Read the case study "Economic Impact of States declining Medicaid Expansion."
Recall that Medicaid is a joint federal and state entitlement health insurance program. The ACA of 2010 required all states to eliminate the use of categories to determine eligibility and expand the Medicaid program to all persons beneath the age of 65 with incomes at or below 138 percent of the Federal Poverty level. However, in June 2012 the U.S. Supreme Court ruled that requiring states to expand their Medicaid programs was unconstitutional: each state could choose to expand the program or not. By 2014, 27 states and Washington, D.C., had opted to expand Medicaid; 23 states had declined expansion; and 4 states were undecided. Declining expansion means that Medicaid continues as it was pre-ACA with categorically based eligibility. The result of the Supreme Court ruling is a system that makes no sense: millions of people will remain uncovered by Medicaid in the states with no expansion because they are too poor to participate in the health insurance exchanges and don't fall into a need-based category to receive Medicaid. Under the ACA, 100 percent of the increased cost of covering more people on Medicaid will be borne by the federal government until 2016. 
2) Review the information in the Washing Post article "Review of Prostate Cancer Drugs Provenge Renews medical Cost-Benefit Debate" (FILE UPLOADED)
3) Consider how policy decisions currently are made about what will and will not be paid for and what changes, if any, could improve the process.
4) Reflect on how the Washington Post example illustrates the tension between cost and care.
Write an analysis and assessment of the ethical and economic challenges related to policy decisions such as those presented in the Washington Post article. How does this type of situation contribute to the tension between cost and care? Substantiate responses with at least two outside sources (preferably < 5 years old).
*Limit the use of "I" (first persons) in writing


Financing Of Health Care
Financing of Health Care
With increased number of people being diagnosed with prostate cancer, the Centers for Medicare and Medicaid services conducted a national coverage analysis to consider the use of a new vaccine to treat prostate cancer. The analysis is meant to determine if the government should pay for the vaccine to available for prostate cancer patients, despite the treatment being too costly (Stein, 2010). The decision to review the policy has generated mixed reactions from several stakeholders
The Centers for Medicare and Medicaid services is mandated to determine the type of treatment to be covered by the federal health plan without necessarily looking at the cost (Stein, 2010). Under the ACA of 2010, all states are required to expand its Medicaid programs to benefit persons under 65years with low income (National Health Expenditures, 2010). Accordingly, the ACA states that 100 percent of the increased cost of covering people on Medicaid will be incurred by the federal government until a review is conducted (National Health Expenditures, 2010).
The decision to review the use of prostate cancer drug has generated a cost benefit debate with stakeholder from drug companies, lawmakers, prostate cancer patients, advocacy groups and cancer experts voicing their concerns (Stein, 2010). Decisions related to policies are determined by analyzing economic and ethical benefits (National Health Expenditures, 2010). The federal government of the US inclusion of Provenge drugs as part of the Medicare treatment plan has raised

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