Happy New Year and welcome to a new era in American Society.
The year 2014 has ushered in immense changes in government policy, with the implementation healthcare coverage for Americans nationwide under the Affordable Care Act, or Obamacare.
One significant consequence of Obamacare, foretold in official channels yet overlooked by many Americans until this past fall, is a spike in Medicaid enrollment. Upon closer scrutiny of healthcare.gov, individuals and families across America have discovered themselves unable to include supposedly affordable healthcare in their already stringent budget. The minimum monthly payment outlined in Obamacare’s Bronze plan (the lowest amount outside of a Catastrophic plan, provided for US citizens under the age of 30) is still over $300, a crippling figure for the millions of Americans still recovering from the 2008 recession.
The government’s solution has been to offer subsidies to make up the difference in costs or, as a simpler alternative, to expand Medicaid coverage to those with income that falls within 133 percent of the US poverty line. Medicaid, once an option of last resort, has become a great equalizer. The percentage of new enrollments who have elected Medicaid over Obamacare has been astronomical, with 82 percent in Kentucky, 87 percent in Washington, and 64 percent in New York State favoring Medicaid.
As an attorney who specializes in Medicaid fraud, I can only shake my head and speculate at the likely influx on my caseload come 2015. Medicaid officials promise a new, more stringent program to prevent fraud. Given the crackdown that has been in place the past three years I do not doubt their voracity. However, the system as it stands is full of holes and oversights that enables fraudsters to thrive and erroneously persecutes low-income clinics or Ambulette services that have served their patients for decades.
Can we bring balance to this system in the New Year? Or will Medicaid continue its cycle of charitable entrapment? With millions of newcomers flooding public healthcare, human error is unavoidable; thousands of Americans will misreport their medical records, or miss deadlines to file their proof of income. The government will be forced to either re-calibrate what constitutes Medicaid fraud, or fill the courts years into the future. Only one thing is certain as we learn alongside our national leaders – adequate legal counsel will become a necessity for all.