Medicare & Medicaid the Two Research Paper

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In 2003, President Bush expanded Medicare, by subsidizing prescription drug costs under Part D.

There are further changes to Medicare and Medicaid in the Affordable Care Act. There were expansions in the number of preventative health care services offered for free (such as colorectal screening), and by closing gaps in prior coverage (HHS, 2012). Berenson (2010) notes that the ACA pays for this expanded coverage by decreasing Medicare spending by reducing payments to private plans under Medicare Advantage and reduced payments for many providers. There are fears that this will cause many providers to either refuse Medicare patients or that the quality of care will be lowered. There are also changes to the structure of Medicare, the end result being more government intervention on the cost side of the program, in an attempt to use the program's bargaining power with health care providers to lower its costs.

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It is possible that providers will decrease the quality of service in response to the lower payouts, but there is also the possibility that providers will improve their efficiency in order to maintain profitability via improved throughput and lower variables costs, thereby allowing them to serve patients just as effectively and at a lower cost. Which of these scenarios comes to pass as ACA is rolled out is yet to be known, but the legislation does put some of the coverage under Medicare and Medicaid at risk while simultaneously increasing coverage in other areas.

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