Assignment: A demonstration Project

Assignment: A demonstration Project

Assignment: A demonstration Project

At the same time, state governments are concerned about their increasing Medicaid costs and about providing healthcare to uninsured people who are not eligible for Medicaid. Massachusetts passed legislation in 2006 to address some of these concerns. By 2010, the percentage of uninsured in Massachusetts had dropped to 6.3 percent from 10.9 percent in 2006. However, the deliberate absence of cost controls imposed by the state resulted in per capita health spending that was 15 percent higher than the national average (Kaiser Family Foundation 2012b).

Driven by increased Medicaid spending by the states, state governments are encour- aged to experiment with new delivery and financing mechanisms by filing a 1115 Medicaid waiver with the Centers for Medicare & Medicaid Services (CMS). In the waiver applica- tion, the state can ask permission for a demonstration project (typically for five years) that allows the state to fund or deliver care to Medicaid patients in that state in a unique way intended to improve access, quality, or both at a reduced cost (CMS 2016b).

While the ACA originally mandated that all states expand the eligibility for Medicaid from 100 percent of the poverty level to effectively 138 percent of the poverty level, the US Supreme Court ruled that mandate unconstitutional in 2012. To encourage states to expand Medicaid eligibility, the federal government offered to pay for 100 percent of the expansion cost for three years and 90 percent of the expansion cost thereafter. As of mid-2016, 31 states and the District of Columbia had accepted the offer (Kaiser Family Foundation 2017a).

nAtIonAl HeAltHcAre reform In March 2010, President Barack Obama signed into law the ACA and the Health Care and Education Reconciliation Act (HCERA), which made important modifications to the ACA. The law followed a century of debate on universal healthcare coverage and months of legislative maneuvering by Democrats and Republicans.

You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.