Transcript Private Non-Group Medicaid* Employer

Health Insurance Coverage of the Nonelderly,
2010
56.2%
EmployerSponsored
Insurance
18.5%
Uninsured
19.8%
5.5%
Medicaid*
Private Non-Group
266 M Nonelderly
* Medicaid also includes other public programs: CHIP, other state programs, Medicare and military-related
coverage. Numbers may not sum to 100 due to rounding.
SOURCE: KCMU/Urban Institute analysis of 2011 ASEC Supplement to the CPS.
Medicaid plays a critical role for selected
populations
Percent with Medicaid coverage:
All Nonelderly Individuals
Poor
Near Poor
43%
26%
Families
All Children
34%
Low-Income Children
Low-Income Adults
59%
22%
Births (Pregnant Women)
45%
Aged & Disabled
Medicare Beneficiaries
People Living with HIV/AIDS
Nursing Home Residents
20%
47%
70%
SOURCE: Kaiser Commission on Medicaid and the Uninsured and Urban Institute analysis of ASEC Supplement
to the CPS; Birth data from Maternal and Child Health Update: States Increase Eligibility for Children's Health
in 2007, National Governors Association, 2008; Medicare data from USDHHS.
Medicaid Facilitates Access to Care for Nonelderly
Adults
Employer/Other Private
Medicaid/Other Public
Uninsured
53%
30%
10%
10%
No Usual Source
of Care
26%
12%
10%
7%
Postponed Seeking Care
Due to Cost
4%
Went Without Needed Care
Due to Cost
In past 12 months.
Respondents who said usual source of care was the emergency room were included among those not
having a usual source of care. All differences between the uninsured and the two insurance groups are
statistically significant (p<0.05).
SOURCE: KCMU analysis of 2011 NHIS data.
The elderly and disabled account for the majority
of Medicaid spending
Disabled 15%
Elderly 10%
Disabled 43%
Adults 26%
Elderly 23%
Children 49%
Adults 14%
Children 21%
Enrollees
FY 2009 = 62.6 million
Expenditures
FY 2009 = $346.5 billion
NOTE: Percentages may not sum to 100 due to rounding.
SOURCE: KCMU/Urban Institute estimates based on data from FY 2009 MSIS and CMS-64, 2012. MSIS FY 2008 data were
used for MA, PA, UT, and WI, but adjusted to 2009 CMS-64.
Medicaid spending growth per capita was slower
than private health care spending from 2007 to
2010.
5.5%
3.4%
3.4%
3.3%
2.5%
1.1%
Medicaid
Medicaid
services per acute care
enrollee
per enrollee
Medicaid
LTC per
enrollee
0.9%
NHE per
capita
Private
health
insurance
per enrollee
Medical care
CPI
Note: Acute Care includes payments to managed care plans.
Source: Medicaid estimates from Urban Institute analysis of data from the Medicaid Statistical Information System (MSIS), Centers for
Medicare and Medicaid Services (CMS) Form 64, and Kaiser Commission and Health Management Associates data, 2011. Private health
insurance and GDP data from Centers for Medicare & Medicaid Services Office of the Actuary, National Health Statistics Group, 2011.
Medical care CPI from the Bureau of Labor Statistics, Consumer Price Index Detail Report Tables, 2011.
GDP per
capita
Expanding Coverage Under the Affordable Care
Act
Federal Poverty Level
56%
EmployerSponsored
Insurance
10%
400%+
37%
139-399%
(Subsidies)
18%
Uninsured
20%
Medicaid*
54%
<139%
(Medicaid)
6%
Private NonGroup
266 M Nonelderly
49.1 M Uninsured
* Medicaid also includes other public programs: CHIP, other state programs, Medicare and military-related
coverage. The federal poverty level for a family of three in 2012 is $19,090. Numbers may not add to 100 due
to rounding.
SOURCE: KCMU/Urban Institute analysis of 2011 ASEC Supplement to the CPS.
Uninsured Adults By Income, 2010
<139%
FPL
(Medicaid)
52% (21.6 M)
139%
FPL+
48% (19.6 M)
Total Uninsured Nonelderly Adults= 41.2 Million
Adults includes all individuals aged 19-64. The federal poverty level for a family of three in 2010 was
$18,210. Percentages may not sum to 100 due to rounding.
SOURCE: KCMU/Urban Institute analysis of March 2011 Current Population Survey, Annual Social and
Economic Supplement.
The Federal Government Will Pay for the Large
Majority of Medicaid Coverage Costs in Health
Reform
Federal
95.4%
$443.5 Billion
Total: $464.7 billion over 2014-2019
Note: Adults less than 133% FPL under standard participation scenario.
SOURCE: Analysis for KCMU by The Urban Institute, May 2010
State:
4.5%
$21.1 Billion