Protect Your Business From All Kinds Of Harm With This Advice

When you own a business, making sure that it is safe should be one of your top priorities. But, it is not always easy to know the kind of things that you need to do to make this happen. Don’t worry th...

News Company - avatar News Company

Expect tax cuts and an emptying of the cupboards in a budget cleanout as the billions roll in

Prime Minister Morrison and Treasurer Frydenberg will do their best to leave the cupboard bare next Tuesday while still delivering a budget surplus in 2019-20.ShutterstockIt has been just over three m...

Warren Hogan, Industry Professor, University of Technology Sydney - avatar Warren Hogan, Industry Professor, University of Technology Sydney

Morrison flags new laws to stop social media platforms being 'weaponised'

Scott Morrison is foreshadowing tough new criminal laws to crack down on social media companies which fail to quickly remove footage like that streamed by the gunman in the New Zealand massacre.Under ...

Michelle Grattan, Professorial Fellow, University of Canberra - avatar Michelle Grattan, Professorial Fellow, University of Canberra

Australian political journalists might be part of a ‘Canberra bubble’, but they engage the public too

Australian journalists often use Twitter to comment on the issues of the day.Nina Maile Gordon/The Conversation, CC BY-NC-NDThe federal election is fast approaching – less than 100 days away in ...

Axel Bruns, Professor, Creative Industries, Queensland University of Technology - avatar Axel Bruns, Professor, Creative Industries, Queensland University of Technology

A new twist in the elusive quest for the origins of the word 'bogan' leads to Melbourne's Xavier College

Drawing of a 'bogan doll' which featured in a 1984 edition of a student-produced Xavier College magazine Sursum Corda.Author providedBogan is the most significant word to be created in Australian Engl...

Bruce Moore, Honorary Associate Professor in the School of Literature, Languages, and Linguistics, Australian National University - avatar Bruce Moore, Honorary Associate Professor in the School of Literature, Languages, and Linguistics, Australian National University

Massacre is now part of Christchurch's identity, so how does a city rise above that?

Christchurch has a challenging new aspect to its identity. The city is now inextricably associated with the March 15 mass shootings at two mosques. So how does a city come to terms with and recover fr...

Will Rifkin, Chair in Applied Regional Economics and Director, Hunter Research Foundation Centre, University of Newcastle - avatar Will Rifkin, Chair in Applied Regional Economics and Director, Hunter Research Foundation Centre, University of Newcastle

Schools are asking students to bring digital devices to class, but are they actually being used?

Not everyone has a digital device to bring to school.from shutterstock.comIt’s been over ten years since Kevin Rudd’s Digital Education Revolution placed small laptops (also called Rudd-to...

Nicola F. Johnson, Associate Professor of Digital Technologies in Education, Edith Cowan University - avatar Nicola F. Johnson, Associate Professor of Digital Technologies in Education, Edith Cowan University

Older people are more digitally savvy, but aged care providers need to keep up

Moving into aged care can affect a person’s ability to remain connected to their local community, but most aged care facilities don't provide access to digital devices.from www.shutterstock.com...

Dr Wendy Wrapson, Senior Research Fellow, Auckland University of Technology - avatar Dr Wendy Wrapson, Senior Research Fellow, Auckland University of Technology

Pets and owners - you can learn a lot about one by studying the other

The personality of a pet owner can help a veterinarian understand the health and welfare of the pet.Shutterstock/PM ProductionThere’s an old saying that pets and their owners become more similar...

Paul McGreevy, Professor of Animal Behaviour and Animal Welfare Science, University of Sydney - avatar Paul McGreevy, Professor of Animal Behaviour and Animal Welfare Science, University of Sydney

Shorten to announce Labor's 'living wage' plan but without an amount or timing

Bill Shorten will unveil on Tuesday a process to have the Fair Work Commission phase in a “living wage”. But he will not say what it should be as a proportion of the median wage, or how lo...

Michelle Grattan, Professorial Fellow, University of Canberra - avatar Michelle Grattan, Professorial Fellow, University of Canberra

Health check: can eating certain foods make you smarter?

Green vegetables, nuts and berries are among the foods that could improve our brain function.From shutterstock.comTrying to keep up with what constitutes a “healthy” diet can be exhausting...

Margaret Morris, Professor of Pharmacology, Head of Pharmacology, UNSW - avatar Margaret Morris, Professor of Pharmacology, Head of Pharmacology, UNSW

A skilful and stirring one-man treatment of George Orwell’s Animal Farm

Renato Musolino is the beating heart of a new production of Animal Farm.James HartleyReview: Animal Farm, State Theatre Company of South AustraliaIn a new one-man production, Renato Musolino brings Ge...

Lisa Harper Campbell, Lecturer in Drama, Flinders University - avatar Lisa Harper Campbell, Lecturer in Drama, Flinders University

Expect tax cuts and an emptying of the cupboards in a budget cleanout as the billions roll in

Prime Minister Morrison and Treasurer Frydenberg will do their best to leave the cupboard bare next Tuesday while still delivering a budget surplus in 2019-20.ShutterstockIt has been just over three m...

The Conversation - avatar The Conversation

A chess program helped this 8-year-old raise $240,000 and get his family out of a homeless shelter – here's what to look for in a chess program for your child

Third-grader Tanitoluwa Adewumi was crowned as a New York State Scholastic chess champion on March 10.GoFundMeBefore he won the primary (K-3) championship section of the New York State Scholastic Cham...

Alexey W. Root, Lecturer in Education, University of Texas at Dallas - avatar Alexey W. Root, Lecturer in Education, University of Texas at Dallas

The promise and peril of the Dominican baseball pipeline

Boys practice baseball at a park in San Antonio de Guerra, a small municipality in the Dominican Republic.Reuters/Ricardo RojasLatinos will comprise about 30 percent of Major League Baseball rosters o...

Rob Ruck, Professor of History, University of Pittsburgh - avatar Rob Ruck, Professor of History, University of Pittsburgh

Why the Vatican needs to open its archives on Pope Pius XII

Pope Pius XII.AP PhotoPope Francis announced recently that, in 2020, the Vatican will open to researchers its archival materials related to Pius XII, who served as pope from 1939 to 1958. The Vatican ...

Alan Avery-Peck, Kraft-Hiatt Professor in Judaic Studies, College of the Holy Cross - avatar Alan Avery-Peck, Kraft-Hiatt Professor in Judaic Studies, College of the Holy Cross

Saudi women are going to college, running for office and changing the conservative country

Saudi Arabia is a notoriously difficult place to be a woman.The kingdom enforces a strict interpretation of Islamic law that sees the separation of men and women as a defining aspect of an Islamic soc...

Alainna Liloia, Graduate Associate, Ph.D. Student, University of Arizona - avatar Alainna Liloia, Graduate Associate, Ph.D. Student, University of Arizona

Why Trump's recognition of the Golan Heights as Israeli territory matters

Israeli Prime Minister Benjamin Netanyahu, center, Republican U.S. Sen. Lindsey Graham, left, and U.S. Ambassador to Israel David Friedman, right, in the Israeli-held Golan Heights on March 11, 2019Ro...

Dina Badie, Associate Professor of Politics and International Studies, Centre College - avatar Dina Badie, Associate Professor of Politics and International Studies, Centre College

Despite consumer worries, the future of aviation will be more automated

Human pilots, surrounded by automation.Sorbis/Shutterstock.comIn the wake of the Lion Air and Ethiopian Airlines crashes of Boeing 737 Max planes, people are thinking about how much of their air trave...

Stephen Rice, Associate Professor of Human Factors, Embry-Riddle Aeronautical University - avatar Stephen Rice, Associate Professor of Human Factors, Embry-Riddle Aeronautical University

We need to stop conflating Islam with terrorism

The Christchurch terrorist attack has shown us that we need to address the threat posed by far-right extremism to our ideals of peaceful social cooperation in a multicultural society. Unfortunately, i...

Nicolas Pirsoul, Sessional lecturer in Middle Eastern Politics, Australian Catholic University - avatar Nicolas Pirsoul, Sessional lecturer in Middle Eastern Politics, Australian Catholic University

Huawei exposes critical weaknesses. We need the infrastructure to engage with China

The European Commission has decided to ignore US calls that its allies keep Chinese tech giant Huawei away from significant telecommunications infrastructure. Britain, France and Germany had already m...

Alice de Jonge, Senior Lecturer, International Law; Asian Business Law, Monash University - avatar Alice de Jonge, Senior Lecturer, International Law; Asian Business Law, Monash University

From Mahometan to Kiwi Muslim: history of NZ's Muslim population

New Zealand Muslims have come from several parts of the world, including Pacific Islands, Asian countries, the Middle East and Africa.AAP/Martin Hunter, CC BY-SAMuslims make up just over 1% of New Zea...

Eva Nisa, Lecturer in Religious Studies, Victoria University of Wellington - avatar Eva Nisa, Lecturer in Religious Studies, Victoria University of Wellington

Plant Hire For Small Businesses

All companies face challenges. However, small businesses face a unique set of challenges. From restricted resources to client dependency, there are various hurdles you need to overcome if your busines...

News Company - avatar News Company

image'Premium assistance' at premium prices. Jonathan Bachman/Reuters

Upon the signing of the Affordable Care Act on March 23, 2010, the public was promised that all US citizens would receive health care coverage.

As Vice President Joe Biden put it at the signing of the bill: “You have turned, Mr President, the right of every American to have access to decent health care into reality – for the first time in American history.”

This changed in 2012 when the Supreme Court ruled in NFIB v Sebelius that states could opt out of expanding coverage for low-income uninsured adults under their Medicaid programs. Many poor adults, especially those without children, were ineligible for Medicaid before the Affordable Care Act came into effect.

As a result, many low-income Americans – about 4 million – still do not have access to health care coverage. Today, 23 states refuse federal money to pay for the cost of expanding coverage to many of their uninsured citizens.

In these states many people living in poverty receive no benefits under the ACA. They earn too much to qualify for Medicaid, but too little to be eligible for tax credits to subsidize private plans in the health care marketplace.

So what would have been a substantial redistribution of funding from the federal government to our poorest states has instead meant that many of our most vulnerable Americans are completely left out of the benefits of the ACA.

This happens, despite the fact that in many of these resistant states, the majority of their citizens favor accepting federal funding to expand Medicaid.

Resistant states

So why are some states refusing to expand coverage when the federal government will pay for most of it? Today the federal government is paying for 100% of the expansion, and will cover 90% from 2019 on. There are two answers.

First and foremost, this is a politically motivated response. The states refusing to take part in the expansion are all led by Republican governors, and many of these states have Tea Party leaning state legislators. There is adamant opposition towards expanding a government program. This is the case even though almost all the states contract out with private plans to provide coverage to Medicaid enrollees.

The second reason is that in many states adoption of the Medicaid expansion would mean a sizable proportion of the state’s population, up to a third, would be covered by Medicaid. This is because most states refusing to adopt the Medicaid expansion tend to be poorer states and have a history of setting very stringent eligibility levels for Medicaid.

To qualify for Medicaid a family or individual can earn up to 138% of the FPL – which isn’t very much money. In the past many poor states set their Medicaid eligibility levels very low. For example, Arkansas set its level at just 17% of the federal poverty level. The Medicaid expansion therefore represents a sizable increase in enrollment.

People are often surprised by how many Americans are eligible for Medicaid. Surprised because the federal poverty level (FPL) for a family of four is just US$23,850. The sad truth is that Americans are poorer than we are willing to admit, and that means a large proportion of people do need to rely on Medicaid for health-care coverage. And sadder still, the leaders in our poorest and reddest states do not want a third of their state residents relying on Medicaid.

Federal Medicaid funding

Despite political resistance to the Medicaid expansion, there are enormous financial pressures pulling these states towards adoption. Put simply, they are giving up a lot of federal money when they do not expand.

Many governors in resistant states argue that the federal government is untrustworthy and cannot be counted on to maintain their funding promise. And, not surprisingly, these governors do not want to invest state funds (10% of the cost of the expansion from 2019) to expand a program they don’t support.

The federal government has never reneged on its financial contribution in Medicaid’s 50-year history. In fact, since these states opted out of expanding Medicaid they have ended up spending more of their own money to cover the costs associated with medical care for the uninsured.

So, the pull towards adoption is strong and real, which helps explain why some Republican-controlled states, like Arkansas, have now adopted the Medicaid expansion. The irony is that the key to their adoption of the Medicaid expansion is a steadfast rejection of Medicaid.

The Arkansas model: an exercise in irony

Arkansas was the first and best example. The state adopted the “Private Option” or what is also called “Premium Assistance.” Under this model, the state allows all newly eligible Medicaid enrollees, an estimated 200,000 people, to choose a private health plan through the federally-run marketplace. The goal, as stated by the key designer of the Arkansas plan, Andrew Allison, is to expand private coverage and downsize Medicaid.

Under a waiver, the federal government allows Arkansas to pursue this approach and still receive federal matching funds. Similar “private” approaches are being pursued in Iowa, Ohio, Pennsylvania and New Hampshire. While this rhetoric allows designers to convince their Republican-dominated state legislators to move forward with the Medicaid expansion, it’s strange that in these same states marketplace contracting with private plans is considered a “government takeover.” This truly shows the power of political framing in real time.

There are other profound ironies. The Arkansas plan may end up being one of the more generous and costly programs in the country. Costly, because paying the cost of private insurance premiums is much higher than the equivalent of what the state paid Medicaid providers. But, generous, because Medicaid enrollees in Arkansas may have access to the same private plans, and their network of providers, as other middle-class Arkansans – something no other state has ever achieved.

Although Medicaid coverage has proven to be crucially important for providing access, it has also been considered a lower tiered program primarily because access is restricted to a relatively small set of providers who primarily take care of low-income uninsured and those with public insurance. The Arkansas approach may break down that two-tiered system. If so, the private sector will be lauded, while the substantial amount of public federal funding, which fuels this new “private option” will remain hidden from view.

image

Colleen Grogan receives funding from Robert Wood Johnson Foundation to organize bi-partisan workshops on the implementation of the ACA to help improve communication between researchers and practitioners. Any other grants have been related to academic research on the Medicaid program.

Read more http://theconversation.com/how-arkansas-is-expanding-medicaid-without-actually-expanding-medicaid-33160