Historic overview of the Health Care Law in USA

Theodore Roosevelt, at the beginning of the 20th century had a dream which is to establish health insurance for all citizens of the United States of America. Back then, a great resistance that seemed already an irreconcilable dichotomy appears:the intervention of the government on some topics versus the freedom of choice of citizens in a free market economy.

Theodore Roosevelt thought that no country would be strong whose people are sick and poor. (1)

He drafted a bill in 1915, but opposition from insurance companies, doctors and labors contribute to the failure. At that time they were in opposition of this idea because they were not agree on a compulsory health insurance. It was even called a “paternalistic” reform that would create a state supervision over people’s health.

Franklin D. Roosevelt in the 1930’s established a great plan called the New Deal which included the social security and unemployment insurance for all Americans. He planned a health care reform but its administration was afraid to include a health care reform that would compromise the adoption of the social security bill.

Harry S. Truman had a new idea of what the health care system should be. He thought that everyone should have a health care coverage regardless of his or her employment or non-employment. The opponents to the project called it ‘socialism’ that would consider doctors as slaves, so Truman was never been able to do the reform. He, nevertheless, had focused on the health care for the elderly called Medicare and hospital insurance for aged people. A system of predominant private health insurance offered to the public and public welfares services for the poor was left because of the republican opposition back then. He created federal employees health care benefits program and institutionalized tax break for employers called a sponsored health insurance that cost 150 billions of dollars each year to the government (2).

Lyndon B. Johnson expended Medicare and created Medicaid. Medicare is a federal health care system to the advantage of individuals of 65 years old and over and disabled persons. Medicaid is a federal, state and local funds health care system protection for all ages low-income people (3).

Richard M. Nixon proposed a comprehensive healthcare reform in 1974. He called for building on the existing framework of employer-based insurance and proposed legislation including a mandate on employers to offer coverage. Nixon then resigned.

Ronald Reagan produced expansion of Medicare but it was considered as a catastrophic coverage for senior citizens and prescription drug benefit by the democrats.

William Jefferson Clinton (Bill Clinton) proposed a health-care reform but opposition from the health care industry was strong and republicans won the Senate at the mid-term in 1994 so that the project could not succeed. The critic that has been addressed to Clinton is that he produced a health-care reform behind the scene without preparing and negotiating in advance the project with all the protagonists.

George W. Bush signed the biggest expansions of Medicare since its enactment with the prescription of drug benefit, which is prescription drug coverage; the enrollees pay a co-pay for each prescription, a monthly premium and an annual deductible. The last (4) is an amount that individual pay for eligible medical services. Some costs are deductible as bills for hospitalization, surgery, lab tests, some scans, anesthesia, physical therapy, medical devices like pacemakers, mental health care and chiropractic care.

Barack H. Obama achieved the universal health-care reform via the individual mandate process where each citizen has to subscribe to a health care insurance plan and depending on the plan, they would have to pay premiums based on their income.

The future of the health care reform depends on the new administration’s decisions. On January 13th 2017 New York Time reported that a speedy action has been taking to repeal the Affordable Care Act (ACA). The challenge would be (5) devising their own plan to ensure board access to health care and coverage while controlling costs. Unfortunately, there is no consensus on how to replace the ACA. The opposition warned about the cost  of repealing the law for millions of American.

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References:

1) Www.pnhp.org

2) Landmark: The inside sotry of America’s New Health Care Law: the affordable care act, and what it means for us all, Introduction, Washington Post, April 27, 2010

3) Www.dictionary.com

4) Www.cigna.com

5) ‘House Clears Path for Repeal of Health Law’, New York Time, January 13, 2017

 

 

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Medicaid Benefits for greencard holders

In my everyday practice, I have a question that is constantly asked: is an immigrant entitled to receive benefits from the US government ?

The conditions have been restricted over the time. Here is a very brief answer. The individual has to be a lawful permanent resident to be eligible to medicaid. He must be a qualified non-citizen, meaning he has to reside on the US territory for at least 5 years; or qualified non-citizen entered the US before August 1996.

The exceptions are the asylums, refugees and Cuban and Haitian citizens.

If you are covered by medicaid , it does not affect your chances to become a US citizen.

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For more informations: https://www.medicaid.gov/medicaid-chip-program-information/by-topics/outreach-and-enrollment/downloads/overview-of-eligibility-for-non-citizens-in-medicaid-and-chip.pdf