Public Health Law and Policy: Medicaid Policies and Procedures to Reduce Healthcare Disparities

45 Pages Posted: 1 Jun 2020

See all articles by MiEsha Strickland, MAHLP, MPA (DHA)

MiEsha Strickland, MAHLP, MPA (DHA)

Franklin University; Hofstra University - Maurice A. Deane School of Law, Students ; Cleveland State University - Maxine Goodman Levin College of Urban Affairs

Date Written: June 23, 2019

Abstract

Prior research suggests that in the United States there is a historical fact pattern of “inequality and social economic disparities in regard to minorities, which has led to intentional and unintentional consequences of social injustices against minority groups” (Strickland, 2017). As with many other societal issues geographical information such as location often reveals a connection within the data. For example, low-income relates to poverty low credit scores (“Equifax Places: Credit Rankings, Fraud Index, Avg Score by Zip,” n.d.), lower education attainment and the use of government subsidies(Bureau, n.d.). Race, ethnicity and location also reveal correlating connections to the above references which some argue have created a public health crisis related to stress of lower credit scores (Birkenmaier, Curley, & Kelly, 2015) In addition, the most recent societal concern findings in public health suggest that there are income disparity resulting in inequality in health care disparities among the same minority groups. In other words, the inner connection social determinants such as race and low-income has contributed to healthcare disparities (“Social determinants of health gain traction as UnitedHealthcare and Intermountain build new programs,” 2018).

Furthermore, public health research shows a pattern of (Medicaid) insurance-based discrimination. Most of the research discovered used a connection of income disparity, and inequality which correlations with geographical statistics that support disproportionate healthcare outcomes (Medicaid/Medicare) for minorities as shown in prior research which include supporting statistics (“Are Medicaid’s Payment Rates So Low They’re Discriminatory?,” n.d.).

The challenge is that because the Medicaid rates are often lower than the rate paid by private health insurance companies for health care and often has more guidelines and stipulations for the provider accepting the subsidy. In fact, it is suggested that there are additional fact patterns of physicians refusing to accept Medicaid which raises moral and ethical concerns about the health care providers’ oath to save lives and the duty to treat (“Doctors who refuse to accept Medicaid patients breach their social contract,” 2017).

Therefore, findings during this research indicates that healthcare providers are seemingly not motivated to accept or take on new Medicaid patients; which poses the question of whether or not public health can be injured by a reduction in providers to accept Medicaid plans as a method of payment for services, which could also have discriminatory outcomes based on the social determinants of those who qualify for Medicaid. More specifically, Medicaid discrimination, from the prospective of health care, is when providers are refusing to accept Medicaid payment as well as other government subsidies. In fact, the STAT article, suggests that are fact patterns of physicians refusing to accept Medicaid as a form of payment for care which raises moral and ethical concerns. The main concern is that health care providers’ have an oath to save lives and the duty to treat a patient is denied care of access to care is limited based on the type of medical insurance the patient has is a violation of their oath and may have the potential to be considered a breach of the health care providers social contract (“Doctors who refuse to accept Medicaid patients breach their social contract,” 2017).

Most currently, the introduction of the Affordable Care Act (ACA, 2010) and the healthcare reform has reduced some of the health care disparities between private insurances and government subsidies because of the ACA’s goal to create equal opportunities for healthcare insurance for everyone, even for those with prior health conditions formerly legalized discrimination; which allowed health insurance companies to deny coverage based on prior health conditions as stated in the ACA statute . Moreover, the ACA, has bought about several policy implementations to reduce healthcare disparities, discrimination such as insurance based discrimination, quality care, and access to care for Medicaid enrollees (“Affordable Care Act (ACA) âHealthCare.gov Glossary,” n.d.).

Suggested Citation

Strickland, MiEsha, Public Health Law and Policy: Medicaid Policies and Procedures to Reduce Healthcare Disparities (June 23, 2019). Available at SSRN: https://ssrn.com/abstract=3592012 or http://dx.doi.org/10.2139/ssrn.3592012

MiEsha Strickland (Contact Author)

Franklin University ( email )

201 S. Grant Avenue
Columbus, OH 43215
United States

Hofstra University - Maurice A. Deane School of Law, Students ( email )

Hempstead, NY
United States
216-835-6698 (Phone)

Cleveland State University - Maxine Goodman Levin College of Urban Affairs ( email )

1717 Euclid Avenue
Cleveland, OH 44115
United States

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