Eligibility for Medicaid May Be Changed by the Proposed Replacement for Obamacare

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Medicaid has played a big role in keeping millions of Americans adequately insured and protected with a viable health coverage. Specifically designed to make healthcare more accessible to low-income Americans, Medicaid implements a strict standard before an individual can be declared eligible for the benefits offered.

Many of the beneficiaries of Medicaid are elderly or disabled. The program’s existence is crucial to states delivering quality healthcare to their constituents. States and local governments must carefully balance their budgets to have adequate resources to allocate for this program.

Uncertain Future

Medicaid as well as the rest of the components of the Affordable Care Act (Obamacare) remains under threat of repeal and replacement. It had a very close call only recently, but the reprieve is short as another proposal has now been passed by the GOP.

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With Social Security in Trouble, One’s Eligibility for Social Security Disability May Become Unclear

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There has been a number of discussions in Washington about the future of social security in the country. Some argue that it needs major reform. To compound matters, the sum of the President’s actions in recent months seem to imply that disability benefits and social security itself may soon be in danger.

Cost of Social Security Continues to Rise

The Social Security Disability Insurance program has continued to grow in costs over the past few years. In fact, reports estimate that it cost $143 billion back in 2015. As the costs continue to rise, officials are now saying that the disability part of the Social Security Trust Fund may well be completely exhausted by year 2022. Should this happen, benefits would automatically be cut for everyone.

In the past, lawmakers acted urgently to stabilize the disability fund. In fact, in 2015, they transferred funds from Social Security’s main trust fund to help fund disability. This time around, however, this kind of ‘fix’ may no longer work. That’s because the scenario has become more complicated than in previous years.

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Social Security Disability Eligibility Faces Investigation Due to A Slew of Fraud Cases

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Recently, the Social Security Administration has reportedly taken some steps to both identify and assess various fraud risks when it comes to its disability programs. According to the U.S. Government Accountability Office (GAO), the administration had managed to gather information on fraud risks during the past year, but the method had not been systematic. Moreover, the significance, likelihood and impact of all the risks identified was also not assessed. With this, hospitals and healthcare providers need to anticipate possible changes in eligibility requirements.

Fraud in Disability Has Been Going On for Some Time

During the fiscal year 2015, the payments from both Social Security Income and Disability Insurance programs amounted to approximately $200 billion. Currently, the extent of fraud across both programs are unknown.

However, several high-profile cases have made it clear that a number of individuals have managed to obtain millions of dollars in benefits fraudulently. In fact, more than 70 individuals had pled guilty to participating in a social security disability eligibility conspiracy to obtain at least $14 million in fraudulent benefits back in 2014. This is exactly why the GAO was asked to review the Social Security Administration’s fraud risk management.

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