Medicaid, along with the Children’s Health Insurance Program, is the most popular health insurance program in the United States that helps with the expenses related to medical care. It covers a variety of services and supports residents from low-income families who require assistance. The essay provides an overview of the programs and analyzes the eligibility criteria in Georgia, which can be accurate for patients of all ages who need to apply to such a program.
Medicaid program has been presented by the government to assist individuals with a low income by providing the healthcare services free of charge or partially covering expenses to various groups of residents. Medicaid has a broad group of patients that can be eligible for services, including pregnant women, patients with disabilities, parents, and children; hence, it has mandatory eligibility groups. (Eligibility Criteria, n.d.) Such groups include individuals receiving supplemental social security income, pregnant women, or low-income families. However, they also adopt additional programs that can provide coverage for exceptional cases, such as children from foster care.
The process of applying consists of financial and non-financial verification. To determine financial eligibility, Medicaid uses Modified Adjusted Gross Income, which determines either applicant can be eligible for the appropriate program, considering tax filing relationships. The financial limit is determined based on the family size and the chosen plan. In Georgia, there are different income limits for different groups of residents that fall under specific criteria. For instance, the income limit for the individuals who receive Supplemental Security Income is $771 per month for aged, blind, or disabled individuals. (Basic Eligibility, n.d.) The income level for individuals who live in nursing homes is different and constitutes $2,313 per month. (Basic Eligibility, n.d.) Aside from financial verification, individuals also must be a U.S. citizen or have satisfactory immigration status. According to the website of the State of Georgia government, individuals must not only have a low income but also match one of the descriptions, such as pregnancy, blindness, or disability. Also, the person either needs to have a child or be 65 years old or older. (Basic Eligibility, n.d.)
To provide services to a larger amount of individuals, The Affordable Care Act took effect in 2014. The act intended to provide universal health insurance coverage through a “combination of insurance market reforms, mandates, subsidies, health insurance exchanges, and Medicaid expansions”. (Marton, Ukert, Yelowitz & Zapata, 2017) According to the study, the act allowed to increase the proportion of residents enrolled in the program. Hence, it impacted the insurance rate and created better opportunities for patients to receive insurance, especially for families without children, young adults, and people without the degree.
Even though increased enrollment provides more residents with health care services, it may also have adverse effects. Venkataramani (2017) conducted a study to find the connection between the expansion of insurance and children’s health care use. The study revealed that Medicaid expansion is associated with “increased receipt of recommended pediatric preventive care for their children” (para. 3). Hence, the spillover effect of insurance coverage may need to be investigated further and can have an impact on future policy decisions.
Children’s Health Insurance (CHI) programs have been created with a purpose to provide accessible health insurance to children from low-income families. In Georgia, children can apply to PeachCare for Kids program. The program provides various services to uninsured youngsters living in Georgia, such as primary, preventive, and specialist care. The services also include dental and vision care. Aside from that, hospitalization, emergency room services, and mental health care are also covered.
Two main eligibility criteria are citizenship and income verification, and it can take up to 45 days to process the application. To qualify for the program, the child must be a citizen of the United States or a qualified immigrant, and he can apply until the 19’s birthday. The program presents a facilitated appliance process as participants can apply either by mail or in-person, and the appropriate specialist will help to determine the most beneficial coverage based on the family income. The child can fall either under the Medicaid income limit or under the PeachCare limit; however, no separate application is needed. The eligibility is determined by the income level, based on the family size. For instance, the monthly income level for a family with one child is $2571, where the income for four members must reach $5300 (Eligibility Criteria, n.d.). The committee verifies the income each year for the expansion of eligibility. Hence, it is vital to provide the most current information.
It is essential to implement such programs as the ability to receive appropriate care can influence children in a long-term perspective. The study, conducted by Lee (2017), examines the influence of socioeconomic disadvantage and poor health on children, stating that such negative aspects influence children’s cognitive trajectories and reciprocal relationships. Therefore, it has an impact on children’s well-being in adulthood, altering the quality of life. The program as CHI can help to prevent the issue by eliminating such problems that will contribute to the development of a healthy environment.
Considering the facts, Medicaid and Children’s Health Insurance program create fair conditions for the residents who cannot cover the expenses by themselves. The individuals of all ages with various disabilities have an opportunity to receive support for a wide range of services. The government reconsiders and adjusts policy due to the state’s needs to provide the most appropriate care for the patients to maintain a safe and healthy environment.
Basic Eligibility. (n.d.). Web.
Courtemanche, C., Marton, J., Ukert, B., Yelowitz, A., & Zapata, D. (2016). Early impacts of the Affordable Care Act on health insurance coverage in Medicaid expansion and non‐expansion states. Journal of Policy Analysis and Management, 36(1), 178-210.
Eligibility Criteria. (n.d.). Web.
Lee, D., & Jackson, M. (2017). The simultaneous effects of socioeconomic disadvantage and child health on children’s cognitive development. Demography, 54(5), 1845-1871.
Venkataramani, M., Pollack, C.E., & Roberts, E.T. (2017). Spillover effects of adult Medicaid expansions on children’s use of preventive services. Pediatrics, 140(6), 1-8. Web.