The Medicaid Ruling: Why is it Important? [Guest Post]

Self Made: NASE's Blog

Blog With Us

Welcome to the Self Made. This is a blog focused primarily on the self-employed and micro-business and full of fantastic posts by not only our team of experts but by YOU!  We realize that there are many ways to help the small businesses out there which is why we invite other business minded individuals to post here and help the rest of the community as well.

The Medicaid Ruling: Why is it Important? [Guest Post]

Jul 05, 2012

Posted by Mike Beene - Almost lost in the frenzy is the surprising (to most) second part of the Supreme Court’s ruling on the health reform law that designates unconstitutional the portion of the ACA requiring states to accept new Medicaid obligations or else lose all funding. Thus, a state can say no to accepting new Medicaid participants (a projected 2 million people in California, 1.8 million in Texas, 950,000 in Florida…) and not lose the Federal funding they receive for their current Medicaid program.

Briefly, Medicaid is a state-federal partnership which was enacted in 1965 and had obtained full state participation by 1982.The federal government funds, depending on state poverty factors, between 50 and 83 percent of the programs. In exchange, the states must follow certain eligibility restrictions required by the feds to receive funding .The state’s portion is the largest budget expense for each state.

Why is this Supreme Court ruling on Medicaid important? The ACA is projected to add over 30 million people to the health insurance rolls. At least half of those are expected to get their new coverage through the Medicaid system. This is accomplished by requiring states to expand the eligibility requirements and make Medicaid available to nearly all people with incomes below 133% of the poverty level ($30,657 or below avg. household income for a family of four.) Currently, almost every state limits Medicaid to those below the poverty line who have dependent children.

The ACA would have required not only that the states expand their eligibility to add the 16 million or so new enrollees in exchange for new federal funding that would in a few years pay 90% of the program, but if a state refused the new offer and its 10% additional cost portion, the state would lose all of its current Medicaid funding. The court essentially separated the programs and said refusal of the new expansion does not impact current Medicaid operations.

So what? Several points to consider: The state portion of the ACA cost is to some degree forgotten. When the act is presented as deficit neutral, the cost to the states is ignored. States generally have a constitutional requirement to balance their budget. Will they willingly accept a 10% hit? Can they? However, will they want to send their tax money to the feds and get none of it back while funding the programs of other states? Will this become a hot political issue in the election? This portion of the ruling highlights the reason many consider this ruling the most important in our generation concerning the federal-state power struggle.  It will be interesting to see if this portion of the opinion becomes a bellweather to future state and federal fights or a footnote. I predict the former.

Questions/comments can be submitted to advocacy@nase.org.


Helpful Tips for Organizing and Managing Your Business Inventory

Helpful Tips for Organizing and Managing Your Business Inventory What started as a hobby, side hustle, or microbusiness is now growing into something bigger and better. That means it’s time to get serious and start implementing systems into your business.   One important part of a small business that often gets overlooked is inventory management. Smart

Written By Ryan M (@pss-california) - Tips and Tricks

7 Profitable Craft Business Ideas for Students to Start in 2024

Are you looking for a unique way to earn some extra cash while unleashing your creative spirit? Crafting isn’t just a fun hobby; it can also be a lucrative business venture. With a bit of imagination and some entrepreneurial spirit, you can turn those skills into a profitable enterprise right from your dorm room.  Whether

Written By Karcy Noonan (@anthonylucas) - How-To Guides / Tutorials

Scent Marketing: How Small Businesses are Using Fragrance to Enhance Customer Experience

In the competitive world of small business, creating a memorable customer experience is key to standing out. One innovative strategy that has gained traction is scent marketing. By incorporating carefully chosen fragrances into their environments, small businesses can evoke emotions, create lasting memories, and even influence purchasing behavior. This article explores how small businesses are

Written By Karcy Noonan (@anthonylucas) - Customer Service Insights

Starting a Bridal Gown Business: Key Considerations and Strategies

As a business that combines elegance, romance, and celebration, the bridal gown industry appeals to those who want to pursue their entrepreneurial dreams. But breaking into this cutthroat market demands careful preparation, ingenuity, and a deep grasp of the workings of the industry. This essay examines crucial factors and practical tactics for starting and expanding

Written By Delilah (@delilah-a) - Best Practices | Tips and Tricks

Overcoming Common Challenges Faced by Online Entrepreneurs

Starting a successful online business is like starting a tug-of-war between your time and money. For early-stage entrepreneurs, you constantly have to ask yourself if you should invest your hours into learning new skills, like web design and video editing, or if you’re better off hiring experts. And then there’s the question of how you’ll

Written By Joseph Muscente (@lendingtree123) - Best Practices

Want More?


See our latest Self Made content by clicking here.  Want to see our archives, click here.

Courtesy of NASE.org
https://www.nase.org/business-help/self-made-nase-blog/self-made/2012/07/05/The_Medicaid_Ruling_Why_is_it_Important_Guest_Post