Pros and Cons of Medicaid Review

Pros and Cons of Medicaid

Medicaid is a US social welfare program that provides affordable health care services to low-income adults and children, elderly people, pregnant women, and people with disabilities. To qualify for the Medicaid program, you must be a US citizen, be able to meet the financial eligibility criteria based on the state of residence, and meet the immigration status requirements. Want to apply for a Medicaid insurance plan? Look at the following pros and cons.


1. Affordable healthcare: Individuals who can’t qualify for premium insurance can have access to healthcare services through the Medicaid program. Some individuals with disabilities can also qualify for payments that help them take care of their daily needs.

2. A continuous stream of customers: Medicaid guarantees medical practitioners a continuous stream of customers. The state provides a lot of physicians and also receives payments for the services they offer to Medicaid members. Some states provide rewarding incentives to practitioners who offer medical services to Medicaid members.

3. Home health services: Medicaid members can receive health care services for those unable to get to the hospitals. Members can also receive transportation to the medical care center.

4. Wider coverage: There is a wide number of services offered to members under the Medicaid insurance plan. Some of these services include inpatient and outpatient hospital services, nursing services, physician services, laboratory, and x-ray services among others.

5. Reduce cost shifting within the economy: Cost shifting occurs when insured Medicaid patients pay more than the uninsured. Medicaid offers monetary coverage to an individual who has incurred bad debts for a certain medical provider, thus reducing the insured cost as well as reducing the cost for those covered.

6. Juicy rewards for medical practitioners: Doctors, nurses, and other medical practitioners who participate in Medicaid are given mouth-watering rewards by the Government. This is to encourage and motivate them for the love and care that they give to their patients. States also offer incentives to the medics.

7. Reduced risk for nonpayment: With Medicaid, the huge medical bills will be taken off the shoulders of patients. Hospitals will less likely face debts or nonpayments of bills. People who are covered by Medicaid are not likely to face out-of-pocket costs. More so, there is an insurance plan for people of all ages and it is for the public option.

8. Emergency physicians earn more: The revenues of average emergency physicians have soared higher following the implementation of Medicaid.

9. No administrative costs: Doctors are dealing with the Government only. This eliminates the extra expenses involved in working with several private health insurers. The rules, billings as well as coverage are standardized and the companies will not spend extra money on hiring staff to deal with the various health insurance firms.

10. No exploitations: There are no exploitations in the cost of health care. The cost is restricted. Health facilities and doctors are not allowed to make more profits by increasing their prices. The cost is low and it remains so notwithstanding whether the patient is rich or poor.

11. More healthy population: Medicaid has leveled up things by making effective health care to be available for both the poor and the old. There is efficient preventive care and it goes a long way in lowering the mortality rate among the populace.


1. Limited to the type of treatment: Medicaid evaluates every treatment plan offered to members. Some procedures may not be offered to the members forcing the members to look for an alternative.

2. Costs taxpayers a huge amount: Offering the Medicaid services put a tax burden on US citizens because part of their tax money is used in funding the program

3. Low reimbursements: Medicaid reimbursements rates are usually lower compared to what doctors charge. This discourages doctors from treating Medicaid patients. The payments also take 30-155 days before they receive it. This makes it difficult for small medical facilities to rely on cash and meet the operational costs.

4. Discrimination of patients: Medicaid patients are a target for discrimination. For example, in nursing homes, elderly patients can be transferred from a private room.

5. Limited healthcare provider options: There are few reputable hospitals that accept Medicaid patients. Some hospitals especially nursing homes refuse to admit patients with Medicaid insurance cover and inform them the Medicaid quota has been met.

6. Long-term care requires extra costs: Although the cost of drugs is restricted, there are other additional costs for patients, especially in the long term. The amount to be spent on health care is under a strict budget by the government. The burden of health care will fall back on the shoulders of the patients when the cost exceeds the budget.

7. There are loopholes in cost restrictions: Some analysts are of the belief that the government may not be able to fully implement cost control in health practices. As such, patients may still experience high bills.

8. Misuse of health care: People hardly attach value to things they don’t spend money on. People may be careless about their health since they know that the finances will not be carried by them.

9. Less attention may be given to patients: The number of patients is ever increasing, so the Doctors may have less time to spend with patients. More so, the budget by the Government is limited. When there are many patients, the Doctors may rush the treatment so as to avoid an increase in the cost of medical care.

10 Long waiting time for rare cases: Some elective health care procedures are likely to face long wait times. This is because the Government focuses more on basic health and emergency care.

11 Absence of drugs and technological facilities for rare conditions: There is a likelihood of the limitation of services by the government. Drugs and technological facilities may not be provided for rare health conditions.