Healthcare Coverage Gap

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The ACA was meant to provide quality health care coverage for all yet a coverage gap for some populations especially in states that oppose Medicaid expansion. Based on what you have learned so far in this course, create a PowerPoint presentation that addresses the coverage gap problem, who is impacted by the coverage gap, the role the ACA plays in the coverage gap, why the coverage gap should be closed, and solutions/ recommendations for closing the gap. Address the following in your PowerPoint:
• Select one state opposed to Medicaid expansion and describe why. Then, consider your own state. What are the benefits and drawbacks to Medicaid expansion in your state?
• Define what the coverage gap is (problem/issue)
• Discuss how the coverage gap impact low income healthcare consumers population.
• What role does the ACA have in widening or closing the coverage gap?
• Why is it important to close the gap (implications for positive social change)?
• What are some solutions to closing the coverage gap and how can healthcare equity help close the gap? Include recommendations and/or solutions.

Sample Solution

Healthcare Coverage Gap

The economic and change in Administration are likely to bring renewed attention to gaps in Medicaid coverage in states that have not expanded eligibility under the Affordable Care Act (ACA). In recent months, millions have gained health insurance coverage through Medicaid as a result of the economic effects of the pandemic as well as the maintenance of eligibility and continuous coverage requirements tied to access to temporary enhanced Medicaid matching funds. However, in the states that have not adopted the Medicaid expansion as of January 2021, Medicaid eligibility for adults remains limited. At a time when many are losing income and potentially health coverage during a health crisis, these eligibility gaps leave many without an affordable coverage option and could contribute to growth in the uninsured rate.

syndrome. Which is mostly observed in childrens with hematuria and mild proteinuria41

Lupus Nephritis: It may result from auto-antibodies (lupus erythematous) binding to circulating antigens, forming preformed immune complexes, or autoantibodies binding to antigens deposited from the circulation in the glomerular vessel walls, causing in situ immune complex formation, with initiation of an inflammatory and cytotoxic reaction.40

Goodpasture’s syndrome (GS) is a rare and organ-specific autoimmune disease that is mediated by anti-glomerular basement membrane (anti-GBM) antibodies43 and has pathology characterized by crescentic glomerulonephritis with linear immune fluorescent staining for IgG on the GBM. It typically presents as acute renal failure caused by a rapidly progressive glomerulonephritis. It was first described as a distinctive syndrome by Pasture in 1919. The disease is caused by autoantibodies against the NC1 domain of the alpha 3 chain of type IV collagen. It occurs when the immune system attacks the walls of the lungs and the tiny filtering units in the kidneys. Without early diagnosis and treatment, the disease can lead to bleeding in the lungs, kidney failure, and even death.42

DIABETIC NEPHROPATHY: It is progressive kidney disease caused by damage to the capillaries in the kidneys’ glomeruli (changes in the blood flow in the small vessels of the glomerular capsule).44It is characterized by nephrotic syndrome and diffuse scarring of the glomeruli. It is due to longstanding diabetes mellitus, and is a major reason for dialysis in many developed countries. It is classified as a small blood vessel complication of diabetes and further it leads to chronic kidney disease (CKD).45

HYPERTENSIVE KIDNEY DISEASE: It is a medical condition referring to damage to the kidney due to chronic high blood pressure. It is also known as “Hypertensive Nephropathy (HN).” HN can be divided into two types: A) Benign and B) Malignant. Benign nephrosclerosis is common in individuals over the age of 60, Whereas

Malignant nephrosclerosis is uncommon and affects 1-5% of individuals with high blood pressure, that have diastolic blood pressure passing 130 mm Hg.46The relative risk of developing ESRD is increased by up to 20 times in hypertensive patients.47

In addition, the glomerulus has a unique structure, with both an afferent and an efferent arteriole, which permits modulation of glomerular perfusion and pressure without corresponding systemic blood pressure change.48

When the force of blood flow is high, blood vessels stretch so blood flows more easily. Eventually, this stretching scars and weakens blood vessels throughout the body, including those in the kidneys. If the kidneys’ blood vessels are damaged, they may stop removing wastes and extra fluid from the body. Extra fluid in the blood vessels may then raise blood pressure even more, creating a dangerous cycle. And opposite

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