THIS IS ONLY AN INTERPRETATION, FIVE SENTENCES AND A QUESTION IS ALL I NEED. TELL ME YOUR THOUGHTS
Mandate requirements that direct states and local governments to provide additional services under the threat of penalties or as a condition of the receipt of federal grant money. Unfunded Mandate is a mandate issued by the national government in which federal funds are not provided. This was seen with the Americans with Disabilities Act. “A mandate is a constitutional provision, a statute, an administrative regulation, or a judicial ruling that places an expenditure requirement on a government” (Mikesell, 2014, p.627).
Medicaid is a joint federal and state program that provides free or low-cost medical benefits to millions of Americans including some low-income families and children, pregnant women, the elderly, people with disabilities, and in some states, other adults. The federal government provides a portion of the funding for Medicaid and sets guidelines for the program. States also have choices in how they design their program, so Medicaid varies by state and may have a different name in your state.
Medicaid in the United States is a social health care program for families and individuals with limited resources. The Health Insurance Association of America describes Medicaid as a “government insurance program for persons of all ages whose income and resources are insufficient to pay for health care”.
Just when Florida thought the health care battle was over, Governor Rick Scott (R-FL) was the first governor to announce that he will not accept approximately $1.9 billion dollars in Medicaid funds allocated to his state by the Affordable Care Act. The full act did not take effect until January 1, 2014, unless it is repealed before then and states are not required to begin implementation before the November election. Scott opted the state out of the two optional provisions of the law which are the Medicaid entitlement expansion and the building of insurance exchanges.
Although Florida does have health care programs for citizens with incomes up to 133% of the poverty line, the Patient Protection and Affordable Care Act enables children to stay covered under their parents’ insurance until age 26, while Florida KidCare only keeps children covered until the age of 18. How many families will be unable to afford full priced coverage because Scott denied them subsidized insurance?
The second provision offered building insurance exchanges that resulted in higher insurance premium costs that will be a burden on Florida citizens instead of the federal government. Scott said, “The real problem with health care is that costs continue to rise,” but it must be understood precisely why they are rising and how to supplement the costs. As people are living longer and technology develops faster, more lives can be saved more quickly, and thus the exact treatments and processes that may be included under the umbrella of health care are expanding rapidly. Health care as we see it today will not be the same as what health care will – and should be – in fifty years.
Mikesell (2014) tells of this when he references that, “…mandates can threaten other government programs. If limits constrain a government’s ability to raise revenue, mandates for certain expenditures can endanger the provision of other desirable services” (p.629).
The ACA requires that all individuals be required to have health insurance or pay a penalty. For low-income individuals, in many cases, health insurance comes in the form of Medicaid which is funded by the states (Cowie, 2016). The Affordable Care Act, which was mandated by the executive branch, has had a significant impact on state governments.
Cowie, S. (2016). The Impact of the Affordable Care Act on State Budgets. Retrieved from http://www.nasdaq.com/article/the-impact-of-the-af…
Mikesell, J. L. (2014). Fiscal Administration: Analysis and Applications for the Public Sector (9th ed.). Boston, MA: Wadsworth.