Talk:Medicaid/Archive 1

Mandatory vs. voluntary
On 2006-04-17 at 21:30:17 (UTC) a anonymous contributor at User:137.190.236.56 replaced the following text:
 * State participation in Medicaid is voluntary; however, all states have participated since 1982. In some states Medicaid pays private health insurance companies that contract with the state Medicaid program, while other states pay providers (i.e., doctors, clinics and hospitals) directly to ensure that individuals receive proper medical attention. The State Children's Health Insurance Program (SCHIP) was established in 1997.

...with this text:
 * It is a mandatory joint federal and state program in which federal and state support are ashated based on the state's per capita income (pg.258 Health Care USA: Fourth Edition, Sultz and Young).

I have reverted the article to the earlier text, but have included the edit here in order to open a discussion of this topic.

In my review of the material put out by CMS, the issue of mandatory vs. voluntary are found in descriptions of (1) benefits offered and (2) beneficiaries covered, but not (3) whether a state can opt-out of Medicaid, which appears to be the focus of this edit. The fact is that Medicaid is available in all states, and no state is currently trying to withdraw from the overall program, so it seems that the discussion of forced participation by states is really a moot point, unless a state attempts to completely withdraw from the Medicaid program. As a practical matter this is unlikely to happen, given the strong incentive provided by matching federal dollars.

As the edit removed other useful information (everything after the first sentence) which does not directly related to this topic, I'm inclined leave out this last contribution. Thanks, -- Argon233&ensp;  T &ensp; C &ensp; U  @ &ensp; &para; &ensp; &ang;   &ensp; 23:06, 17 April 2006 (UTC) Bold text


 * Actually, states can opt out of Medicaid. Someone should change the text back to reflect this. --204.113.19.8 20:32, 25 January 2007 (UTC)

Copyright violations
In the introduction, the following two phrases are from http://www.cms.hhs.gov/medicaid/: Any suggestions for changes? Edwardian 18:33, 27 Apr 2005 (UTC)
 * 1) "it pays for medical assistance for certain individuals and families with low incomes and resources"
 * 2) "Medicaid is the largest source of funding for medical and health-related services for people with limited income:


 * I don't think there's any reason to worry about these two. They are both single sentences (quotation would fall under fair use), and they're both exceedingly generic and matter-of-fact, which makes the issue of copyright rather moot. siafu 19:25, 27 Apr 2005 (UTC)


 * OK, it might not be a copyright violation but I do think outright copying of what someone else wrote is not proper. Edwardian 4 July 2005 04:02 (UTC)

Just a side note: In the U.S., federal government documents and websites are not covered by copyright. By federal law, they are in the public domain. --Medinomics 4 July 2005 03:46 (UTC)


 * Why not? Information produced by the federal government belongs to the people.  We pay for it, so we should be able to use it.  That's why it's not covered by copyright.  If it's well-written and factual, there's no reason not to use verbatim government wording.  --204.113.19.8 20:34, 25 January 2007 (UTC)

“While Medicaid and Medicare cover similar groups...”
I believe this statement is technically incorrect. From what I understand, though their target groups do, in effect, overlap in many cases, Medicaid focuses on the financially indigent while Medicare's target group is comprised of those living on a fixed income, regardless of the financial resources available to them. Kokoloko2k3 05:27, 27 Apr 2005 (UTC)
 * In full context, I think the article does a decent job of explaining the differences; however, I think "While Medicaid and Medicare sometimes cover similar groups..." or "While Medicaid and Medicare sometimes overlap..." would be more accurate. Edwardian 18:33, 27 Apr 2005 (UTC)
 * Absolutely needs to be clarified. Medicaid eligibility is based on a) low-income, and b) categories of eligibility: aged, blind, disabled, pregnant, children.  Medicare is based only on age and disability, without regard for income.  In reality, most Medicaid clients are children and pregnant women, and most Medicare clients are elderly.  Not really an overlap, except that there are quite a few low-income elderly on both programs.  Maybe it's a one-way overlap, if that makes sense - a high percentage of Medicare people are on Medicaid, but not vice versa. --204.113.19.8 20:37, 25 January 2007 (UTC)

Just to clarify, I think it's a bit inaccurate to classify those on both Medicaid and Medicare as primarily "low-income elderly." For one thing, a significant proportion of "dual-eligibles" are typically disabled non-elderly adults. But even more importantly, many elderly adults in long-term (nursing home) care are dual eligibles. While some of these adults are low-income, many are essentially middle-class. This goes to a larger point: while the public perceives Medicaid as a program for low-income children and mothers and this group does make up the largest single group of Medicaid enrollees, most of the expenditures on Medicaid go to (a) the disabled and (b) the elderly, particularly those requiring long-term care, which is essentially never covered by Medicare. While the elderly and disabled must be "low-income" to qualify for the program, they are frequently not "poor" in most meaningful senses of the word.

Who is eligible
There is a small contradiction on who is eligible. At one pont low-income parents are mentioned but then that becomes low-income children. But the entire article makes it sound like any low-income citizen is eligible. Which is it?

"Among the groups of people served by Medicaid are eligible low-income parents, children, seniors, and people with disabilities."

"Medicaid is a joint federal-state program that provides health insurance coverage to low-income children, seniors and people with disabilities."


 * Low-income children are always eligible if they meet other requirements. In some states, some low-income parents may be eligible depending on how their program is set up.  --204.113.19.8 20:39, 25 January 2007 (UTC)
 * ...Then it would be appropriate to mention that in the article itself. The article is inconsistent with regards to the program eligibility; if there are differences in eligibility among different states, please be clear and state them.69.156.107.160 06:04, 22 February 2007 (UTC)


 * There's a critical issue here. Medicaid eligibility is not purely based on income, but is "categorical" - to be eligible, you can't just be poor, but you have to fall into a particular eligibility category.  So, low-income children below a certain age (which mary vary by state), pregnant women, parents of Medicaid-eligible children who meet certain income requirements, low-income seniors, and low-income people who meet certain disability criteria.  Each of these describes an eligible group specified by statute.  If you don't fall into one of these categories - say a single young adult or childless couple who are neither disabled nor elderly - then you're not eligible for Medicaid even if your annual income is zero (or negative, for that matter).  This is one significant cause for the U.S. having so many uninsured people with family incomes below the federal poverty line - they're too poor to be able to buy insurance on their own, but aren't eligible for Medicaid.  (As an aside, it's interesting to think about how each of these eligibility categories play politically, and compare them to the political attractiveness of the groups that are left out.)

madecade vs life insurance
Hi!, How are you. My name hyo kim. My mom has madicade but she want get $15,000 amount wholelife insurance for after she die used funeral cost. But she hered someone sade if she got life insurance that time can't service for madicade. Please answer to me right thing. Thank You!! —Preceding unsigned comment added by 68.158.244.225 (talk) 16:21, 24 July 2009 (UTC)

universal healthcare
are there any resources out there that can compare the medicaid in the u.s. vs a universal healthcare programme such as those seen in canada or england? in terms of the quality of care.

I can answer the question about how medicaid compares to Canada, or Britain. Medicaid offers superior coverage. There is no copay, and the medicine costs $1. Medicaid pays private insurers like Kaiser. All of the service you recieve will be private, the same as paying out of your pocket. This means that the system won't be backed up like you would see in Canada, Britain, or Europe. Instead of waiting one year to see a specialist, you will get treated much faster under medicaid than you would in Canada. Medicaid is probably the best healthcare you can get anywhere in the world.


 * You're comparing apples with oranges. Medicaid is NOT a universal health care system.  Captain Quirk (talk) 14:34, 2 November 2009 (UTC)

Payments
There is no mention in this article of what Medicaid actually does: namely, pay health care providers (doctors, nurses, therapists), hospitals, and long term care facilities.

It would be good to cover some of this. I'm constantly surprised that my patients don't understand that, because I am a participating Medicaid provider, that their Medicaid pays me about one-quarter of the going rate for a Medicare patient for the services they receive, and also prohibits me from charging them for the balance. They think that I am getting a good deal on caring for them when in fact I do it below cost, as charity work.

208.73.14.242 (talk) 01:45, 27 June 2010 (UTC)

Cost estimates
Editors don't seem to want the readers to see that estimates of health costs have been pretty horrible in the past, just to get them through Congress and by the public. I don't understand why these figures cannot be published. Yes, they are embarrassing, but that is not my fault! They are true, however. Erasing items you don't like is not the way mature editors deal with real facts. Student7 (talk) 19:26, 29 July 2010 (UTC)


 * Student7 should stop their WP:Disruptive editing of the Medicaid    and Medicare (United States)     articles—repeatedly adding false and misleading material (mis)citing UNRELIABLE sources.
 * An  opinion column  by Col. John D. Beeson, USAF (Ret) in the July 2010 The INTERCOM newsletter of the Cape Canaveral Chapter, Inc. of the Military Officers Association of America quoting an October 20, 2009 Wall Street Journal  editorial   is  not  a WP:NPOV or WP:Reliable source.
 * A silly ("All currency figures in this paper are in nominal form, i.e., unadjusted for inflation") partisan July 31, 2009  opinion paper  by the Joint Economic Committee Republican staff on the Joint Economic Committee Republicans website  is  not  a WP:NPOV or WP:Reliable source.
 * An article by Washington Times staff writer David M. Dickson in the conservative Washington Times that quotes a silly ("All currency figures in this paper are in nominal form, i.e., unadjusted for inflation") partisan July 31, 2009  opinion paper  by the Joint Economic Committee Republican staff  on the Joint Economic Committee Republicans website  is  not  a WP:NPOV or WP:Reliable source.
 * An August 6, 2009 Wall Street Journal  editorial  is  not  a WP:NPOV or WP:Reliable source.
 * Repeated addition of WP:SOAPBOX misinformation to the Medicaid and Medicare (United States) articles and careless (mis)citation of UNRELIABLE sources by User:Student7, a Veteran Editor IV with 36,000+ edits and no evident sincere interest in the history of Medicaid or Medicare, is disruptive and unacceptable. Apatens (talk) 03:41, 30 July 2010 (UTC)

It seems that all references that disagree with yours are "silly." The Wall Street Journal is generally accepted as WP:RELY.

To say that figures were accurately projected runs counter to prevailing knowledge that most original estimates of costs of social programs were deliberately underestimated to ensure passage. It is possible that a modern GAO might forestall this, but whatever was there in the 1960s and 70s, did not. Student7 (talk) 20:22, 2 August 2010 (UTC)

Why not have a section that reports critics as saying that costs were underreported, then furnish the accurate reports you seem to suggest were made? Where are the "accurate" estimates, if the ones I have been furnishing are "silly" and "inaccurate?" Student7 (talk) 20:43, 2 August 2010 (UTC)


 * Editorials and op-eds are  never  acceptable in Wikipedia articles for statements of  fact .


 * Even if the "prevailing knowledge" of conspiracy theorists was "that most original estimates of costs of social programs were deliberately underestimated to ensure passage," that doesn't mean their conspiracy theories merit inclusion in an encyclopedia article about Medicaid.


 * An unreliably-sourced section for false and misleading statements by "critics" does not belong in a Wikipedia article about Medicaid. Apatens (talk) 05:27, 3 August 2010 (UTC)


 * You are welcome to stop all these articles, unpleasant references, etc. by citing how correct the founders were in their estimates, and demonstrating how well the programs have been run. These continuing attacks on me and my references would be rendered quite unnecessary. Feel free. Student7 (talk) 20:30, 5 August 2010 (UTC)


 * There don't seem to be any attacks on you personally, and the deconstruction of the references is entirely valid. There is no reason to suggest that your interlocutors are responsible for finding references to "prove" you wrong, when all that has been done is the invalidation of your thesis; it's up to you to prove yourself correct.  I have to agree that editorials and op-eds (also editorials) are not WP:RS for facts, though they can be considered RS for the opinions of their writers. siafu (talk) 21:00, 5 August 2010 (UTC)

Eligibility, post-2014
The article notes that currently poverty is a (mostly) necessary but not sufficient condition for Medicaid eligibility, though it somewhat maddeningly doesn't get into what other conditions must be met. Then it mentions that once (if) the health care reform goes into place in 2014, eligibility expands to people earning 133 percent of the poverty level. Do the other conditions go away at that time (i.e. anyone with a low enough income in 2014 is eligible for Medicaid) or are some or all of them still in place? --Jfruh (talk) 15:27, 22 April 2012 (UTC)

universal healthcare in Texas
Everyone in Texas has medical care. Texas has a county hospital system that is paid for by property taxes. The county hospital provides care for anyone who cannot pay. We do not have public insurance because we have the county hospital systems. — Preceding unsigned comment added by 129.119.87.218 (talk) 00:49, 28 August 2013 (UTC)

Eligibility, again
I find this paragraph puzzling.


 * Medicaid is for those who have low incomes. This means that the only people who are covered include: low income children, pregnant women, mothers (when children are young), and people with disabilities who do not have a work history (receiving a Supplemental Security Income, or SSI). Persons with a disability, including blindness or physical disability, deafness, mental illness can apply for SSI which comes with Medicaid. However, one must be unable to work in order to qualify for SSI. So, in order to get Medicaid, one has to declare that one is disabled and then prove that one is so disabled to the point that one could not work (NAMI).

The first sentence states, straightforwardly, the Medicaid is for people for low income. The next sentence starts with "This means..." implying that what it says will follow logically from the first. But it doesn't: instead, it says that to qualify you have to be poor and fall into one of the categories listed. (The construction "the only people who are covered include" is also confusing: "only" implies you have to fit one of these categories, but "includes" implies that there might be other categories that qualify. The whole paragraph ends by saying that you must declare yourself unable to work in order to receive Medicaid benefits, but this is certainly not the case, as many low-income families with children in which one of the adults work are on Medicaid; I assume that what's actually meant is that you must declare this if you want to use SSI as a route to being enrolled in the program.

Adding to the confusion is that requirements vary from state to state (so I'm not sure if this description is true everywhere), and of course on January 1, 2014, in about half the states the only requirement for enrolling in Medicaid will be an income below 133% of the poverty level.

Based on some of the discussion above, I'd like to rewrite this paragraph as follows:


 * As of 2013, Medicaid is a program intended for those with low income, but a low income is not the only requirement to enroll in the program. Eligiblity is categorical -- that is, to enroll you must be a member of a category defined by statute; some of these categories include low-income children below a certain age, pregnant women, parents of Medicaid-eligible children who meet certain income requirements, and low-income seniors. The details of how each category is defined varies from state to state.


 * People with disabilities who do not have a work history and who receive Supplemental Security Income, or SSI, are enrolled in Medicaid as a mechanism to provide them with health insurance. Persons with a disability, including blindness or physical disability, deafness, or mental illness can apply for SSI. However, in order to be enrolled, applications must prove that they are disabled to the point of being unable to work.

I'll update this in the next day or so unles anyone has objections. The subhed should probably also be changed to "eligibility" as that's what's actually discussed. --Jfruh (talk) 22:16, 26 August 2013 (UTC)


 * I've added the rewrite. Feel free to fix any errors or mistakes, obviously. --Jfruh (talk) 01:07, 28 August 2013 (UTC)

Update for 2014 data
I adjusted text to reflect in reading that the Medicaid Expansion is now in effect, I added the latest status of expansion states, to bring information to a current and correct representation I added cost sources, to further clarify the program for the readers SpekServices (talk) 15:30, 10 January 2014 (UTC)
 * Thanks for making those edits, I was planning on making some updates as well but you already had it covered. I'll keep checking back to see if there's anything else that might need to be fixed as time goes on. Adamh4 (talk) 18:38, 28 March 2014 (UTC)

Links
>> Medicare Millionaires Totaling Almost 4,000 Seen in Data(Lihaas (talk) 14:51, 9 April 2014 (UTC)).


 * The article you link to is about Medicare, not Medicaid. They are different programs. --Jfruh (talk) 12:04, 11 April 2014 (UTC)

"Eligibility and benefits"
Dental services: not clear what "required" vs. "optional service" signifies; who is required to do what?

Coconutporkpie (talk) 10:30, 13 November 2014 (UTC)

Tennessee?
Governor Haslam in Tennessee is proposing a compromise to Medicaid Expansion called "Insure Tennessee" which aims to be similar to Arkansas's reform. He said he will press the Tennessee State Legislature this year (2015) to pass Insure Tennessee.

Sources:

http://www.tennessean.com/story/news/health/2015/01/23/copays-disenrollment-set-insure-tennessee-apart/22244175/

http://www.tennessean.com/story/news/politics/2015/01/05/politics-threaten-haslams-insure-tennessee/21266523/

--Beneficii (talk) 23:24, 26 January 2015 (UTC)

HIV
I was doing some research and the information I found about public programs and HIV/AIDS patients is that it's Medicare (not Medicaid) that provides funding for AIDS patients. Medicaid differs vastly between the states and it is Medicare's coverage of chronically disabled people that foots the bill for HIV patients after they fall into the disabled category. From the social security website, once you are on social security disability for two years, you automatically qualify for Medicare. (http://www.ssa.gov/pubs/10029.html#part10)

Granted, having Medicare coverage when you have HIV isn't very useful due to the "doughnut hole" in Part D, but in any case, the section on Medicaid covering HIV medications is misleading at best and downright wrong at worst. —Preceding unsigned comment added by 174.16.141.207 (talk) 01:50, 23 March 2010 (UTC)

I agree completely additionally there is a severe lack of citations. I will add the template (Citation Needed) and then attempt to rewrite this sectiobm posting the revised here for discussion. T S Ballantine (talk) 22:05, 8 February 2017 (UTC)

American Health Care Act
The American Health Care Act is suggesting some huge changes to Medicaid. Editors who are interested should take part in the article. Casprings (talk) 21:36, 10 March 2017 (UTC)

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needs more than I can do right now
I came here wanting to update that the Center for Medicaid and Medicare services approved Arizona's petition to exempt tribes from work requirements based on federal trust responsibility for Native American health care, according to incoming Navajo Nation president Jonathan Nez. The reference for that would be: "cite news| title=Leaders applaud Medicaid announcement | publisher=Navajo Times | date=January 24, 2019 |page=C3"

However, there is no mention in the article of work requirements. Requires research Elinruby (talk) 00:52, 27 February 2019 (UTC)

Mass-removal of peer-reviewed academic research
An editor removed eight or so peer-reviewed academic studies published in several of the top public health, econ and poli sci journals with the strange claim of "this is all one-off primary research". As WP:RS makes clear, peer-reviewed studies "are usually the most reliable sources". Wikipedia should include more peer-reviewed academic content, not less. Snooganssnoogans (talk) 22:50, 21 January 2019 (UTC)
 * @Snooganssnoogans Should be reverted if it hasn't been already. I think it's safe to say it's ok to restore. Elinruby (talk) 00:54, 27 February 2019 (UTC)

Noticeboard discussion regarding 's recent edits
There is a noticeboard discussion regarding the neutrality of 's edits to this article (Special:Diff/909480199/909790623) and other articles related to Medicaid estate recovery. If you're interested, please participate at. —  Newslinger  talk   17:17, 30 August 2019 (UTC)

Trump blocks Medicaid usage by states, add?

 * https://www.latimes.com/politics/story/2020-03-13/trump-administration-blocks-states-use-medicaid-respond-coronavirus-crisis

The Trump administration blocked states from using Medicaid to expand medical services as part the response to the COVID-19 pandemic. During major disasters, the Centers for Medicare and Medicaid Services has traditionally loosened Medicaid rules, allowing states to quickly sign up poor patients for coverage so they can get necessary testing or treatment. Until now, Trump has been reluctant to declare a national emergency, as previous administrations did after the 9/11 terrorist attacks, Hurricane Katrina, and the H1N1 flu, because it would contradict with his repeated efforts to downplay the seriousness of the pandemic. X1\ (talk) 07:27, 18 March 2020 (UTC)

Privatization and Automation of Medicaid in Indiana
It appears that the text in this section is more focused on the pitfalls of welfare system privatization than on encyclopedic-type information about Medicaid. Although the points presented may be valid (I have not read the references), the discussion seems more appropriate for the WP page on Privatization. Also, the first 2 of the 3 paragraphs deal mainly with one event (the contract signed by Gov. Daniels) that occurred 15 years ago in a single state. Again, the points and concerns raised may be valid, but it seems like a reader interested in basic Medicaid knowledge would find this misplaced or even distracting. What do other editors think? Should we delete or move this discussion? Howbeit (talk) 15:29, 18 February 2021 (UTC) — Preceding unsigned comment added by Howbeit (talk • contribs) 15:26, 18 February 2021 (UTC)


 * I think that entire section should be removed. I agree, it speaks (at least in the text) more to Welfare than Medicaid, and the sources (I haven't read them) don't APPEAR in title to be discussing Medicaid.  I don't think it (as written) would be relevant anywhere else, either, so I vote for deletion. --- Avatar317 (talk) 21:22, 18 February 2021 (UTC)


 * I just tried to make the section as encyclopaedic as possible, but I definitely think it's garbage content and can be deleted if necessary. It only presents a few sources clearly used to make an argument, no matter how much you reword it. However, if anyone is interested in rewriting and finding sources to actually describe the situation as a controversy like the way that Oregon is described in one of the sections above, I'm all up for that and I'll change my vote. Shotgunscoop (talk) 00:07, 19 February 2021 (UTC)

POV tag at top of article
Do you have any specific areas where this article is POV, OTHER than the Indiana section? If not, than I think we should remove the article tag at the top. Or can you articulate what you mean for the article overall? I haven't read the entire article, but I didn't notice anything glaring. Thanks! --- Avatar317 (talk) 04:04, 19 February 2021 (UTC)
 * I'm going to remove this tag until a consensus emerges for its inclusion. It is not at all evident that any article-wide neutrality issues exist. I would of course be open to being persuaded, but it would be up to Shotgunscoop (or anyone else who's interested) to make the case. Generalrelative (talk) 04:23, 19 February 2021 (UTC)
 * I definitely think that in a complex issue such as Medicaid (especially Medicaid expansion), there will be more than one noteworthy side to each argument, and that each side should be covered, or at least mentioned, in the most complete way possible. In this case, the anti-Medicaid argument is barely touched on, with only minute references (some of which I have removed), and doesn't really represent the conservative perspective well. Each of the studies cited is distinctly pro-Medicaid. I'm not saying that both sides of the argument must carry the same weight, but I do believe that this article is heavily pro-Medicaid in its sourcing and needs some contrasting information to balance it out, which is why I added the POV tag. Shotgunscoop (talk) 13:39, 19 February 2021 (UTC)
 * We go by what reliable sources say, preferably secondary ones. Where they disagree, we give WP:DUE weight. This should not be confused with an imperative to represent "both sides" where conservative and progressive perspectives differ. If you have reliable sources that you think would help us better capture the breadth of mainstream academic understanding on the topic, I would be happy to discuss them here. Generalrelative (talk) 14:55, 19 February 2021 (UTC)
 * The way I see it is that if we can find good reliable sources giving a conservative view, or we know that those types of sources are out there but that the article fails to include them, (written from only one POV) then that would be cause for a POV tag, though preferably on a specific section, since I would tend to believe that sections like "Features" and "History" would generally not be political or disputed.


 * Do we have any good sources detailing the argument against expansion? or Medicaid in general? (obviously large costs = tax increases involved...maybe studies of the detriment to GDP from increased taxes vs. slightly more productive workers if they are healtier?) --- Avatar317 (talk) 23:02, 19 February 2021 (UTC)


 * I did find an article from the Kaiser Family Foundation, which as already been cited in the article, that gave an overview on ideological and financial reasons that people would be against Obamacare, such as the policy of requiring people to have health insurance or pay a tax penalty (individual mandate) and increasing premium costs for some people and being forced to give up better coverage. Here is the link: https://khn.org/news/why-do-people-hate-obamacare-anyway/. I do think we need to find more historical arguments against Medicaid to represent due weight, perhaps detailing a dissent made in Congress or something. Shotgunscoop (talk) 16:38, 20 February 2021 (UTC)


 * That is definitely a source. But of course the Obamacare individual mandate was not directly related to the topic of Medicaid –– and in any case it's hardly relevant to contemporary debates at all since it was struck down in 2019. To merit an article-wide POV tag (and the kind of systematic overhaul it calls for), we would need to show that there is a broad scholarly literature which criticizes Medicaid directly, and which the article as written ignores. Generalrelative (talk) 19:20, 20 February 2021 (UTC)