Medicare and Medicaid Overview

Medicaid and Medicare are two distinct government-operated and funded projects for American citizens. While both programs are health insurance schemes, there are variances in cost allocation and supported services. Medicare offers medical insurance to people above 65 and people below 65 who are disabled, regardless of their income. On the other hand, Medicaid is a relief program that serves low-income earners of all age groups. This essay discusses the variations between Medicare and Medicaid, the outcome of health care reform initiatives on both programs, and how Medicare has progressed to adapt to society’s changing needs.

The distinction between Medicare and Medicaid is that Medicare is fundamentally age-based, and Medicaid is an income-based health scheme aiding individuals with inadequate financial supplies. According to Decarolis and Guglielmo (2017), Medicare is accessible to help people above 65 or under 65 years with distinct medical disorders. It applies to the eligible individuals and not the whole family. Venkataramani, Pollack, and Roberts (2017) explain that the government established Medicaid to assist individuals and families with financial constraints to obtain health care. Moreover, an individual can register for Medicaid when their condition warrants it because they do not have to wait for an open application period.

Plans A and B of Medicare do not consist of dental protection, for instance, tooth removal, fillings, cleaning, and other dental services. Medicaid may indemnify protective dental care for the elderly in some states and treatment in other states. This contrasts from one state to another and is advantageous over Medicare. In some exceptional cases, Medicare Plan A may indemnify dental care if obtained in a hospital, which would not always constitute regular dental care services. In contrast, Medicaid compensates for children’s dental health and pays for vision health, such as eye examination, in many states. Medicare may involve a preliminary vision test as a portion of Medicare P B insurance in the “Welcome to Medicare” protective visit.

The Medicare structure that is currently in place is different from the one that was in 1965. As additional requirements and anxieties are apparent, Medicare has adjusted the social welfare strategy to accommodate the selected population’s needs. Initially, Medicare only formed the program to benefit adults who are 65 and above with health coverage. The program expanded the policy to constitute people under 65 years with prolonged disabilities and end-stage kidney illness. Decarolis and Guglielmo (2017) describe that Medicare did not enforce Plan C until 1997 through the Balanced Budget Act. Medicare did not authorize Plan D until 2003 through The Medicare Prescription Drug Improvement and Modernization Act. The scheme paid for the full-service fee as established by the specific doctor. As Medicare expenses started to increase, the legislature opted to change the compensation technique to offer fixed-rate reimbursement for provided services.

Another unique way Medicare has changed over the years is in respect to its rates to the client. Medicare Plan A and B have experienced changes in the duty-free and premiums that individuals pay. Since Medicare’s inception, Plan B’s duty-free has grown from USD 40 per year to USD 1,184 per year in 2013, as per Ginsburg and Patel’s (2017) establishment. Ginsburg and Patel (2017) elaborate that Plan B’s premium has grown from USD 3 to USD 104.90 monthly for people with an annual income of not more than USD 85 000 in 2011. The increase in Medicare expenses enlightens how Medicare has advanced as medical costs increase.

Furthermore, the requirement for health insurance among the old and the disabled has risen. In research done by Wang and Trivedi (2017), the federal formed the scheme to assist all qualified beneficiaries as a general welfare policy. One effect of health care reform initiatives on Medicare or Medicaid is that widening health insurance coverage to all American citizens will increase medical. According to Courtemanche, Marton, Ukert, Yelowitz, and Zapata (2017), the Congressional Budget Office approximated that investing in uninsured people will rise by 0.25 percent to 0.6 percent. The definite increase will depend on the costs reimbursed to health caregivers for treating uninsured clients. Lee and Jackson (2017) additionally indicate that the Congressional Budget Office approximates that the amended law decreases the federal arrears by USD 143 billion over a decade, from 2010 to 2019. The office will incorporate funds to Medicare and Medicaid, emerging from health structure reconstruction.

Moreover, minimizing employer expenditure on health insurance results in increased salary and wage payments levied by the government. While The Congressional Budget Office reported some of this impact in current estimations, the office can anticipate further minimization in employer spending on health insurance from reconstruction and reduced management costs. Before the reform, the federal predicted Medicare expenses to increase by 0.068 percent yearly from 2010 to 2019, as indicated by Courtemanche et al. (2017). Executing these net Medicare funds bends the Medicare expenditure curve and decreases the predicted yearly growth rate to 0.055 percent, as further established by Courtemanche et al. (2017). Finally, reducing insurer management and upgrading healthcare services will lead to a reduction in private insurance covers.

In summary, Medicare and Medicaid programs are different in cost allocation and supportive services. Medicare has evolved to accommodate the community’s changing needs, for instance, government adjustment to the social welfare strategy, and by subsidizing the duty-free and premiums, individuals pay. Finally, health care reforms’ impact is that health insurance cover will raise medical expenditure and decrease federal arrears. The legislature also opted to change the compensation technique to offer fixed-rate reimbursement for provided services.


Courtemanche, C., Marton, J., Ukert, B., Yelowitz, A., & Zapata, D. (2017). Early impacts of the Affordable Care Act on health insurance coverage in Medicaid expansion and non expansion states. Journal of Policy Analysis and Management, 36(1), 178−210. Web.

Decarolis, F., & Guglielmo, A. (2017). Insurers’ response to selection risk: Evidence from Medicare enrollment reforms. Journal of Health Economics, 56, 383−396. Web.

Ginsburg, P. B., & Patel, K. K. (2017). Physician payment reform–progress to date. New England Journal of Medicine, 377(3), 285−292. Web.

Lee, D., & Jackson, M. (2017). The simultaneous effects of socioeconomic disadvantage and child health on children’s cognitive development. Demography, 54(5), 1845−1871. Web.

Venkataramani, M., Pollack, C. E., & Roberts, E. T. (2017). Spillover effects of adult Medicaid expansions on children’s use of preventive services. Pediatrics, 140(6), 1−8. Web.

Wang, J., & Trivedi, A. N. (2017). Enrollment in California’s Medicaid program after the Affordable Care Act expansion. American Journal of Public Health, 107(11), 1757−1759. Web.

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