Transcript 50 Million Uninsured: The Faces Behind the Headlines

Medicaid Coverage and Spending
Diane Rowland, Sc.D.
Executive Vice President,
Henry J. Kaiser Family Foundation
and
Executive Director,
Kaiser Commission on Medicaid and the Uninsured
for
Alliance for Health Reform Briefing:
Inside Deficit Reduction: What it Means for Medicaid
Washington, DC
November 10, 2011
FIGURE 1
Health Care Coverage and Personal Health Care
Expenditures in the U.S., 2009
Health Spending
Health Coverage
Other Government
Programs
4%
Total = 300 million
Total = $2.1 trillion
SOURCE: Health insurance coverage: KCMU/Urban Institute analysis of 2009 ASEC Supplement to the CPS. Health
expenditures: KFF calculations using NHE data from CMS, Office of the Actuary
FIGURE 2
Medicaid has many roles in our health care system.
Health Insurance Coverage
29 million children & 15 million
adults in low-income families;
15 million elderly and persons
with disabilities
Assistance to Medicare
Beneficiaries
Long-Term Care
Assistance
8.9 million aged and disabled
— 21% of Medicare
beneficiaries
1 million nursing home
residents; 2.8 million
community-based residents
MEDICAID
Support for Health Care System
and Safety-net
State Capacity for Health
Coverage
16% of national health spending;
40% of long-term care services
Federal share can range from 50 - 83%;
For FFY 2012, ranges from 50 - 74.2%
FIGURE 3
Most beneficiaries are children, but the elderly and
disabled account for the majority of Medicaid spending.
Total = 59.5 million
NOTE: Percentages may not add up to 100 due to rounding.
SOURCE: KCMU/Urban Institute estimates based on data from FY 2008 MSIS and CMS Form-64, 2010.
Total = $317.7 billion
FIGURE 4
Disability and long-term care drive higher per-enrollee
spending.
$14,481
Long-Term Care
$12,499
Acute Care
$5,163
$2,135
$2,541
SOURCE: Kaiser Commission on Medicaid and the Uninsured and Urban Institute estimates based on 2007 MSIS and
CMS64 data.
FIGURE 5
Duals Account for 39% of Medicaid Spending.
Medicaid Enrollment
Medicaid Spending
Premiums
4%
Medicare
Acute 6%
Adults
25%
Other
Acute
2%
Other Aged &
Disabled
10%
Duals
15%
Non-Dual
Spending
60%
Children
50%
Long-Term
Care 27%
Prescribed
Drugs 0.4%
Total = 58 Million
Total = $311 Billion
SOURCE: Urban Institute estimates based on FFY 2007 data from MSIS and CMS Form 64, prepared for the Kaiser
Commission on Medicaid and the Uninsured, 2010.
Dual
Spending
39%
FIGURE 6
Medicaid spending growth per enrollee has been slower
than growth in private health spending.
SOURCE: Urban Institute, 2010. Estimates based on data from Medicaid Financial Management Reports (HCFA/CMS Form
64), Medicaid Statistical Information System (MSIS), and KCMU/HMA enrollment data. Expenditures exclude prescription
drug spending for dual eligibles to remove the effect of their transition to Medicare Part D in 2006.
FIGURE 7
Enrollment was the largest driver of Medicaid spending
during this last recession.
SOURCE: Urban Institute, 2010. Estimates based on data from Medicaid Financial Management Reports (HCFA/CMS Form
64), Medicaid Statistical Information System (MSIS), and KCMU/HMA enrollment data. Expenditures exclude prescription
drug spending for dual eligibles to remove the effect of their transition to Medicare Part D in 2006.
FIGURE 8
Federal share of Medicaid spending (FMAP) varies by state.
Statutory Federal Medical Assistance Percentages , FY 2012
WA
VT
MT
ME
ND
NH
MA
MN
OR
MI
WY
IL
UT
CO
CA
RI
PA
IA
NE
NV
NY
WI
SD
ID
OH
IN
WV
KS
MO
KY
VA
CT
NJ
DE
MD
DC
NC
TN
AZ
NM
OK
SC
AR
MS
TX
AL
GA
LA
FL
AK
HI
50 percent
(15 states)
51 – 59 percent (11 states)
60 – 66 percent (13 states)
67 – 74 percent (12 states including DC)
NOTE: Rates are rounded to nearest percent. These rates will be in effect Oct. 1, 2011 – Sept. 30, 2012.
SOURCE: Federal Register,, Nov, 10, 2010 (Vol. 75, No. 217), pp. 69082-69083.
http://edocket.access.gpo.gov/2010/pdf/2010-28319.pdf