Medicaid Budgetary Policy Analysis Research Paper

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Budgetary Analysis

Process for Budgetary Policies and Assigned Legislative Committees

A government budget can be defined as an official contract or arrangement that specifies the amount of revenue to be raised, where such revenues will be sourced, and the manner in which the revenues will be utilized. In most societies, the budget is in actual fact an assortment of policy contracts that specify the tax laws and also the level of spending for particular programs; thus they are more than just a complete and inclusive document. The process for budgetary policies therefore refers to the guidelines and procedures that are employed by policy makers to frame, ratify, and implement these agreements for revenues and spending (Crain, 2004).

For state governments as well as the federal government in America, the process for creating budgetary policies is comparatively simple to define in a conventional manner. Generally, the first phase of the process is the conveying of proposals for spending and revenue. The subsequent step covers the hearing of such proposals which are thereafter debated upon. Once the proposals have been debated, different oversight committees undertake the voting process, and then voting occurs by the complete legislative membership. Once this is done, the bills on spending and revenue are taken for consideration to the chief executive. The final phase of the budgetary process for policies is similar and comparable to the other kinds of legislation. This implies that the budget bills can end up becoming law in two different ways. The first one is that after consideration, the chief executive can sign the bill and then it becomes law. On the other hand, if the chief executive refuses to sign the bill, it can still become law by attaining the approval of a super majority voting outcome from both houses of the legislature (Crain, 2004).

The budget process mentioned above is the regular process for all budgets passed. However, when a major crisis like Hurricane Katrina occurs, more individuals and families become eligible for governmental assistance such as Medicaid. This compels states to draft problematic budgetary choices; for instance, moving funds from optional programs like K -- 12 school financing to Medicaid Match funds. In reaction to this quandary, a supplemental appropriations process for budgeting is initiated. Supplemental appropriations are planned to make available extra funding to an agency or program in the course of a given current fiscal year so as to safeguard against budgetary deficits or shortages. Every now and then, supplemental appropriations make funding available for approvals that take place subsequent to the normal budgetary process, whereas at other times the appropriate authorization has been in position for a relatively short period of time (Black, 2009).

As soon as the supplemental appropriations entreaty is initiated, it is taken to the House and Senate Appropriations Committees. The President of the United States (POTUS) usually ensigns supplemental appropriations with an emergency label or title. This characteristically permits supplemental appropriations to receive less scrutiny and inquiry. In accordance to Black (2009), spending established to be for an emergency, by both the POTUS and U.S. Congress, is effectually exempted from deficit targets and budget caps requirements. In addition, it is not required of the President to take account of normal budget validation information in supporting these requests (Black, 2009).

Once the President submits a budget, the congress is expected to adopt the budget resolution. In this particular phase, the Senate and House Budget Committees are responsible for forming the Budget Resolution. This in particular institutes the new budget authority and expenditure levels for the financial period that is encompassed in the resolution. If everything goes well, every chamber of the Senate and House has Budget Committees that offer their account of the Budget Resolution for contemplation within their specific chamber (Black, 2009). Any disparities that arise between the two versions of the budget resolution are settled and taken into account in the Conference Committee. Once the Budget Resolution is ratified as expected, the House and Senate Committees on Appropriations, at that juncture, start developing the twelve appropriations bills that find the middle ground with the federal budget. Every one of the twelve bills is picked up by the different appropriation subcommittees. The allocations, also referred to as the ceilings in terms of spending, are additionally split among these sub-committees. The Committee on Appropriations, for both the House and Senate, offers up any differences to the conference committee for a compromise. Once this is done, the bill is able to be presented to the president for signing into law (Black, 2009).

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How budgetary changes affect the community

According to Snyder and Rudowitz (2015), Medicaid accounted for one dollar out of every six dollars spent on healthcare in the United States. This is the key source of financing for states to provide insurance to meet the health needs not just in the present, but also in the long run for the low-income earners. The Medicaid program is mutually financed by states and the federal government. When the economy is adversely impacted due to high unemployment or when natural disasters come about, this increases the need for higher amounts for Medicaid. This implies budget changes in order to accommodate these instances. It is imperative to take note that these changes do affect society both in a positive and negative manner. On the positive note, these budgetary changes help in the quick responsiveness by the state to the changing needs of the populace. The budget changes warranty states federal matching dollars for the eligible expenditures, sanctioning federal monies to flow to states on the basis of definite expenses and requirements. This implies that in difficult times, for instance during a natural disaster, federal payments can enable the state to cater for any additional costs of healthcare and medication (Snyder and Rudowitz, 2015).

However, these changes do have an adverse impact on the society as well. When such budget changes take place, different areas of state services are impacted. Some of these areas include K-12 education, higher levels of education, services offered to elderly individuals, and the disabled, as well as other areas (Johnson et al., 2011). The federal and state governments choose to make these cuts for the reason that the revenues collected for these services are all employed to pay for the additional coverage and health care services for the low income residents. This in turn negatively impacts the educational sector. For instance, local school districts have to downsize or cut down on the educational services they provide. Leachman and Mai (2014) state that the new budgets of the different states are providing less per-student financing for kindergarten through 12th grade compared to previous funding. Schools in approximately 33% of the total states have to start the new educational year with less state funding compared to the previous year. This is a negative aspect, because at a time when government states and the nation-state are making an attempt to bring about work-forces with the expertise to control and dominate new knowledge, and acclimatize to the intricacies of a global economy, the deterioration in state educational outlay is cause for great worry (Leachman and Mai, 2014). In addition, Bohn et al. (2013) assert that funding for higher education in society ends up being relentlessly reduced, causing a huge amount of fiscal agony for the state's community colleges. The budget changes make it more and more challenging for the colleges to take into account their missions; and as a result several state residents fail to attain the educational skills and proficiencies that they require to succeed in the contemporary economic environment.

Prioritized Recommendation between deficit and cuts, or a surplus and additional funding

Deficits and cuts should be recommended for prioritization over a surplus and additional funding. According to Cooper (2010), a survey undertaken indicated that seventy percent of Americans consider reduction in deficits to be very important. Additional funding and a surplus to some extent can be deemed to be stimulants to the economy. However, James (2010) indicates that for every dollar that is spent in America, 41 cents are borrowed and are actually 'debt'. This can injure the economy in the long run and therefore harm different sectors such as healthcare and education. This implies that it could affect the state and federal funding of Medicaid and Medicare.

The Political Climate of the State of North Carolina. How does this drive the agenda? How does this differ from developing legislation?

The Patient Protection and Affordable Care Act give the states in the nation two options to choose from. The first one is whether to offer a state-centered exchange for the acquisition of subsidized private health insurance, while the second one is whether to increase Medicaid (the health insurance program for the poor jointly funded by the state and federal government). Expanded Medicaid would cover all residents and long-time lawful inhabitants proximate to, or underneath the federal poverty line. Different from most original predictions, more than half the states have declined to form their own insurance.....

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