Discussion Questions

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Jomo Kenyatta University of Agriculture and Technology *

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HCBA3215

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Nursing

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Nov 24, 2024

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1 Health Policy Initiatives and Medicaid Student Name Institutional Affiliation Instructor's Name Course Date

2 Question #1 By influencing the license regulations, health policy initiatives shape and control the nursing practice of an Advanced Practice Nurse (APN). State licensing laws restrict APNs' licenses, which impacts their nursing procedures. The policy restricts the practicing power of this nursing group in several jurisdictions. As a result, Medicaid payment for APNs is inconsistent and requires physician monitoring. An advanced practice nurse must only collaborate with other healthcare professionals on one aspect of the practice ( Gysin et al., 2019 ). It is prohibited for APNs to engage in clinical practice without external health professionals' direct supervision or team leadership. Restricted healthcare policies hinder access and the provision of high-quality care. In addition, potential APNs are unable to practice autonomously because of it. The payment rules do not acknowledge APNs as primary caregivers, even though healthcare laws differ from state to state. Most plans forbid paying APNs directly for care services or granting them credentials. Instead, APNs must bill their services through a doctor to be paid. For instance, the Medicaid standards mandate that APNs only provide follow-up treatment when a physician has authorized it. Question #2 The three states chosen for consideration are Louisiana, Mississippi, and Texas. There are several similarities in the Medicaid eligibility requirements for the three states. Firstly, all three states provide coverage for those who care for children, expectant mothers, persons who make less than minimum wage, older adults (those 65 and older), and disabled individuals (Brooks et al., 2019). One must be a citizen of one of the three states to meet the Medicaid eligibility requirements. Regardless of these similarities, the Medicaid eligibility of the states differs slightly in terms of income threshold and covering for non-citizens. The precise income level that ought to be covered by the Medicaid program varies depending on the income restriction. In Louisiana and Texas, the income ceilings primarily rely on household size (Brooks et al., 2019). However, specific percentages above the federal poverty line must

3 be met in Mississippi to qualify. Besides, Medicaid in Mississippi covers emergency treatments for all non-citizens, especially unrecorded immigrants, as long as their income cap and eligibility requirements are met for natives (Medicaid.gov, 2019). Non-citizens must legally be permanent residents of Louisiana or Texas to be eligible. Lastly, Louisiana permits Medicaid coverage for underinsured women with cervical and breast cancer disorders. Furthermore, the variations in Medicaid eligibility requirements between the three states may impact those residing in either state. Individuals under Medicaid in one state could find themselves not eligible in another. As a result, they may not obtain healthcare services, according to the changes in eligibility rules. The variations in the eligibility requirements in the three states could also impact healthcare accessibility for the different vulnerable populations, especially in light of the Medicaid program's role in improving access to healthcare. For example, women in Texas and Mississippi with breast cancer without insurance might not have access to high-quality care. APNS must comprehend the requirements for Medicaid eligibility for the numerous states to enhance effective healthcare services planning.

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4 References Brooks, T., Roygardner, L., Artiga, S., Pham, O., & Dolan, R. (2019). Medicaid and CHIP eligibility, enrollment, and cost sharing policies as of January 2019: Findings from a 50-state survey. San Francisco: Kaiser Family Foundation. Accessed January , 22 , 2020. Medicaid.gov. (2019). Medicaid coverage - mississippi division of Medicaid . Mississippi Division of Medicaid -. Retrieved from https://medicaid.ms.gov/medicaid- coverage/#:~:text=You%20must%20be%20a Gysin, S., Sottas, B., Odermatt, M., & Essig, S. (2019). Advanced practice nurses’ and general practitioners’ first experiences with introducing the advanced practice nurse role to Swiss primary care: a qualitative study. BMC family practice , 20 , 1-11.

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