Part I
One primary scope of the arrangements contained in the Affordable Care Act (AC) is the extended qualification of Medicaid to low-pay to people that has salaries at or below 138% of destitution (GOBankingRates, 2016). The extension thus fills the crevices in the record of Medicaid qualification for adults in a move deemed as one to steer out protection scope to the people with low salaries, premium duty credits for scope filling in market places as well as cover individuals having direct salaries.
The Medicaid was initially supposed to be national but the Supreme Court in June 2012 made it discretionary for states. Nineteen states had not yet extended their projects as of September of the year 2016 (GOBankingRates, 2016). The qualification of Medicaid in states that never extended their projects remains very restricted for instance, the middle salary for guardians in the year 2016 was 44% of the destitution that makes a yearly wage of $8,870 per year for a group of three. Grown-ups remain ineligible for in almost all childless states (GOBankingRates, 2016).
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| State | Insurance Cost | Comment |
| New York | $366 per month | Higher than the set national medium |
| Mississippi | $278 per month | Lower than set national medium |
| Texas | $253 per month | Lower than the set national medium |
Texas is the most suitable state among the three states because of the low costs and significant other factors as described below.
It is also well to appreciate that Medicaid does not give assistance to people below neediness for alternatives of other scopes on the basis that the ACA imagined that people with low wages would get a scope in Medicaid. Therefore, many grown-ups, fall into the “scope hole” comprising of earnings that are above the qualification of Medicaid in states that do not grow the Medicaid due the limitation the ACA places on credits of premium assessments (Han et al., 2015). Nearly 3 million people nationwide fall into the scope hole as a result of the choices by states not to extend Medicaid. The above thus implies that such persons have their wages currently above the qualification of Medicaid although below the Marketplace premium duty credits. States such as Wyoming, New York and Mississippi have very high Medicaid qualification premium making them some of the most costly states. However, the state of Wyoming is slightly cheaper than the other two (GOBankingRates, 2016).
Grown Ups left in the scope crevices courtesy of current choices in the states not to extend the Medicaid spread across states having no chance to grow their Medicaid programs and thus packed in states having large populaces that are uninsured. More than a quarter of such persons live in the crevice scope in Texas that has a significant population that is uninsured with extreme restrictions to the Medicaid qualification. On the other hand, 18% of the people live in Florida and 12% in Georgia as 8% live in North Carolina (GOBankingRates, 2016). However, Wisconsin does not have uninsured people because the state gives Medicaid qualification to adults having a destitution level that is under the Medicaid waiver.
Characteristics
The qualities of the persons that comprise the scope greatly reflect the poor and uninsured adults. For instance, in relation to the idea that racial minorities like the blacks and Hispanics are more feasible to need the protection scope than the White non-Hispanics thus probably living in families that have low salaries is evident. The people remain lopsidedly among the poor and uninsured persons remaining among individuals that dwell in the scope hole.
According to GOBankingRates (2016), approximately 46% of the uninsured adults in the scope crevice comprise of the White non-Hispanics, 18 percent of the populace are the Hispanic and 31% are blacks. It is without contradiction that the ethnicity and race of people in the scope hole does well to reflect the contrasts in the ethnic or racial synthesis between various states that advance with the development of Medicaid and the states not growing. A few states like Florida, Georgia and Texas have large black populaces that have not seen an extension of the Medicaid under the ACA (Han et al., 2015). The black community represents an offer of the people living in the scope hole when placed in contrast to the aggregate poor people or grown-ups rather and make up an uninsured populace. The racial and ethnic attributes of the population in the crevice of the scope generally shift by state and reflect on the fundamental qualities of the populace in a particular state.
The old or aged people rather fall into the scope of the hole. It is evident that at least more than half of the old that entails 35 to 54 and the close elderly that entails an age group of 55 to 64 years of age. The grown-ups in these age groups stand to have an expansion in the needs of wellbeing with research showing that uninsured persons in the age range may leave the needs of the untreated till the point when they become noticeably qualified for the Medicare which is at the age of 65. Approximately 21% of the individuals in the scope crevice are reasonably weak despite their reports that they are fine and well (GOBankingRates, 2016). The people have medical issues and are in dire need of therapeutic consideration. It is about and over the exhibit of the uninsured being more outlandish than the protection in getting a preventive look after major conditions in the wellbeing and interminable illnesses. However, the uninsured often confront very expensive visits in the doctor visits when they begin looking for medical care.
Part two
The feeling of being an outcast
People end up feeling like outcasts regardless of the states they reside in, and the states they intend to set off to and more so in the event that there is a less dependable rule. One may find themselves asking questions like why their coffee costs more than that of the local people or why everyone giggles having not understood a joke told (McMorrow, 2015). It is impossible that a person will be made to feel uncomfortable intentionally. However, it remains tiring for the person to consistently keep looking for a way to fit in and socialize with the people. It is imperative that the person does not allow the people the chance or opportunity to demoralize them. I have met many persons across states and most have proven to be neighbourly and promising without minding that I may not be one of them. Eventually the situation usually dies down becoming less influential.
Defeating the boundary of dialect
The boundary of dialect remains one of the most difficulties of concentrate when one travels to another place. The immediate influence of a dialect boundary would suggest that a person assumes another dialect sans prior preparation or one could have thought to have been familiar but find them-selves not comprehending the accent (McMorrow, 2015).
Cash contrasts
Getting used to contrasts in cash also proves a vital challenge. It proves very difficult when in a different country and one has to understand the monetary transactions and valuation of the nation (McMorrow, 2015). One must thus ensure that they work on getting a snappy framework of themselves in order to make rational sense of all costs during the purchase of items and become better acquainted with ordinary costs of staple items.
Being far away from the persons that best known and encourage one
Living in a different state is great and more so when everything is going on well. However, one begins to feel off when things around them start feeling like they are going south. A person begins to miss their brothers and parents as well as friends who may be miles away from them. It is at that point that one begins to treasure how important these persons are and contemplate on how much they never treasured them before. It is a test that most people feel and has the effect of drowning one in deep emotions of frustrations and stress and usually takes a toll on the person barely months after their arrival in the new location.
Adapting to the mistaken assumptions of society
One lacks the foggiest idea concerning the culture of the neighbourhood and all unwritten tenets when they are non-natives in the host country. One will commit various errors and may stand to lack balance. Despite all these, the person should not be humiliated but try to gain from all the social misunderstandings and promise not to make them anymore. The person will become accustomed to the area after a while.
Circumstances for a different state
Costs of insurance
One key factor for the need for one to move into a different state is the costs of insurance. Certain states have high costs of insurance as per the Medicaid in accordance to the restrictions they have set in the ACA. States like Wyoming, Mississippi, New York, and South Carolina charge high premiums for the Medicaid. For instance, New York stands as the most expensive state in terms of the ACA Medicaid health insurance with poorly scored factors. CareConnect offers the cheapest silver plan that has higher deductibles that stand at $3000 and the highest premium per month at $366 that totals $4,392 per annum.
The party that is insured will pay certain co-insurance charges like 25% on the emergency care. A person would do better to move to states that offer cheaper insurance care like Idaho and Oregon. However, the problem with such states is that there is a high level of inaccessibility to the health insurance of uninsured persons. However, the good thing with the state of Idaho is that the costs of insurance are quite low with the lowest silver pan cost in the state being Mountain Health that stands at a premium cost of $266 per month that is the median at the national level. It has a lower deductible of $2150 (Layard, 2011).
Closeness to Initial State
Indeed, there are a number of aspects that must be adhered to in settling for a state most suitable for the poor persons and most importantly the aspect of how near these people are to their relatives. As earlier mentioned, one key problem that a person faces when they traverse to another place is the loss and feeling of missing their people. People miss their neighbourhoods, friends, usual hangout places and relatives (Layard, 2011).
Being that most of these people are poor and cannot afford expensive flights to states or places far away from their initial states, it is important that they move to states that neighbour their original states. By doing so, they will be able to reduce the impedance of having to travel long miles and distances to see their relatives. Therefore, being in a nearby state will allow these persons to adapt quickly to the new neighbourhoods and quickly adapt to the new customs and way of life. Moreover, the nearby states usually have similar ways of doing things and a way of life.
Race and Ethnicity
Many people are influenced by ethnicity and racial stereotypes in the states of America. It is hard fact as earlier mentioned that the minorities of the races and ethnic groups in the United States show different levels of insurance on health in different states (Han et al., 2015). Most of the poor people that seek low level medical insurance come from the minority races like the Hispanics and blacks.
The effect of the above is that certain states in accordance to the majority of the race or ethnic group in the state, set insurance costs to be in delight with the common sense that the ethnic group has. Therefore, a person would do well to go to places where the ethnic group that makes the majority in the area is believed to need or demand for low level insurance costs to cover their medical expenses. It is imperative as this will without a doubt protect the persons coming from poor backgrounds seeking medium costs of insurance to cover their medical bills.
Reasonableness
Hawaii for instance is a state that has a reasonable health insurance cost despite its high cost of living. It furthers ha the best systems of healthcare in the world. It offers a very low silver plan with a monthly premium of $260 that is better than the median number set at $266. It also has very low deductible amounts standing at $2500 (Layard, 2011). Therefore, it would be best for one to relocate to a state such as Hawaii whose living cost is high but the medical insurance is proper.
Conclusion
Medicaid does not give assistance to people below neediness for alternatives of other scopes on the basis that the ACA imagined that people with low wages would get a scope in Medicaid. Many grown-ups, fall into the “scope hole” comprising of earnings that are above the qualification of Medicaid in states that do not grow the Medicaid due the limitation the ACA places on credits of premium assessments. People from vast age groups and disciplines such as ethnicity and poverty levels must find quality places or states rather that allow them to manage their healthcare cover.
References
GOBankingRates,. (2016). 10 Best and Worst States for Health Insurance Costs: Huff Post. Retrieved 8 September 2017, from http://www.huffingtonpost.com/gobankingrates/10-best-and-worst-states_b_9030422.html
Han, X., Nguyen, B. T., Drope, J., & Jemal, A,. (2015). Health-related outcomes among the poor: Medicaid expansion vs. non-expansion states PloS one, 10(12), e0144429.
Layard, R. (2011). Happiness: Lessons from a new science: Penguin UK.
McMorrow, S., Kenney, G. M., Long, S. K., & Anderson, N. (2015). Uninsurance among young adults continues to decline, particularly in Medicaid expansion states. Health Affairs, 34(4), 616-620.
