In America, matters dealing with the Healthcare reform policy undergo through a vigorous political process since it is similar and links to a number of other policy areas, and is part of the general social policy on the nation. It relates to the pursuit of health, delivery of healthcare services, or even employment of healthcare professionals.
The high cost of healthcare is just one of the most enduring problems in America, with both the private and public sectors experiencing the spiraling costs in healthcare. Therefore, this means that the formulation of Healthcare policy is vastly influenced by the diversity and array of both economic and social factors that affect the development of a social policy that promotes diversity at all levels.
Currently, the United States government plays a key role in the financing, directing, and planning of healthcare services. The policy stream in healthcare usually consists of experts and specialists in the field who may both be inside the government or in the private sector, and they advocate their ideas and solutions to the underlying problems.
For this reason, Medicaid is a special healthcare program introduced at all state levels and is financed by both the national and local-state governments with a dedicated purpose of serving persons with disability, families and people with low resources and revenues. However, poverty is not a prerequisite into the Medicaid program as a number of conditions must be met for one to be eligible.
The Kentucky eligibility criteria for the Medicaid program
According to Your Guide to Kentucky Medicaid, to be eligible for the Medicaid program, one must be a U.S citizen or a legal immigrant who has a permanent residence in the U.S (6). Since resource assessment defines ones eligibility into the program, the Kentucky state law demands full disclosure of all resources owned by a person during the application process for this program, and it can either be in terms of an institutionalized spouse or community spouse.
These resources are usually assets such as personal property, retirement accounts, real property, hard-cash, and other convenient assets owned by a person or couple which can be easily converted into cash. Although the assets of an institutionalized individual have a resource limit, the assessment process also verifies a couple’s number of assets which are protected and beneficial for use by the community spouse.
Each couple is then given half of the totaled countable resources and if the assigned half is not greater than the annual maximum resource limits of the community spouses’, it is added on the institutionalized spouse’s fraction which must all be spent before another process of eligibility towards Medicaid is established.
Furthermore, in order to be eligible for the Medicaid program, the Kentucky state law also requires all workers to verify that their assets were not discarded for less than a reasonable market price and any transfers of such resources should be in solidarity with the Medicaid eligibility process, unless the applicant indicates otherwise (4).
The 2006 Deficit Reduction Act also calls for the eligibility process to investigate the previous sixty months from the date of application in order to create a baseline for all transfers of goods and services at fair market value. Therefore, if an applicant fails to exhibit the amount and value of the goods and services during this period, they would be reckoned for a forbidden transfer of resources which is subject to being penalized for a specific period of time (10).
The total amount of all evaluated resources disposed at a less than a fair market value is therefore used to determine one’s ineligibility status and period that is based on a person’s average cost of daily care which is revised on an annual basis. In other words, if the transfer had not occurred, the ineligibility period would begin at the date of transfer or the date the applicant would otherwise be eligible in sequence to any date that occurs last.
In addition, those applicants who do not have a community spouse or even a minor reliant child in their home and also have a home equity that surpasses the 500,000 dollar mark, are technically not eligible for Medicaid, however, the 500,000 dollar cap is subject to change from time to time.
The Children’s Health Insurance Program in Kentucky
According to Kentucky’s health department website on Kids’ Health: Keeping our children healthy, the Kentucky Children’s Health Insurance Program is also known as KCHIP, and it’s a 1997 special Medicaid initiative taken by the state of Kentucky to oversee health coverage to uninsured children at a free or low cost (n p).
To be eligible for the KCHIP initiative the child must be a U.S citizen or have a proof of being a legal ‘resident alien’ and in addition, they should not be having a health insurance.
Within the period of the past six months, the family should also not have ‘dropped’ health insurance on the child on voluntary grounds. To be eligible, it’s mandatory for the child to possess a social security number or should be willing to apply for it.
The KCHIP initiative covers a child’s dental care, hearing services, prescription medicines, doctor visits, vision examinations, hospitalization, psychiatrist sessions, outpatient hospital services, laboratory and X-ray test, and many more.
Both the Medicaid and KCHIP initiatives are all rational in the maximization of public interest and overall health despite the processes being tedious at different levels. In conclusion, we can say that these health initiatives undertaken by Kentucky and other U.S states can bring effective change in the healthcare sector which can be achieved through its policymaking model-of-programs which are dedicated at local level since they understand their urgent health needs.
Kentucky.gov. Kids’ Health: Keeping your children healthy. Web. 22 July. 2011.
‘’Your Guide to Kentucky Medicaid’’. Web. 22 July. 2011.