Changes in Medicaid:. Protecting Medicaid Beneficiaries NAMI Convention June 30, 2006 Judith Solomon, Senior Fellow, CBPP. Topics. How states are using waivers and the Deficit Reduction Act of 2005 (DRA) to change: How Medicaid provides benefits The benefits Medicaid provides
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Protecting Medicaid Beneficiaries
June 30, 2006
Judith Solomon, Senior Fellow, CBPP
Medicaid Costs Less than Private Coverage
Medicaid Costs 30% Less for Adults and 10% Less for Children Than Private Health Insurance
Estimated 2001 per capita costs of serving Medicaid enrollees with Medicaid vs. private insurance, after adjusting for health differences.
Source: Hadley and Holahan, Inquiry, 2004
Average Annual Growth, 2000-2003
1 Holahan and Ghosh, Health Affairs, 2005.
2 CMS Office of the Actuary, National Health Accounts, 2005.
3 Kaiser/HRET Survey, 2003.
Medicaid’s Benefit Package Does Not Itself Increase Program Costs
Medicaid Beneficiaries Already Have Out-of-Pocket Costs for Health Care
>$25,000 in Costs
Total = 46.9 million
Total = $180.0 billion
SOURCE: Kaiser Commission on Medicaid and the Uninsured from Urban Institute estimates based on MSIS 2001 data.
Poor Adults on Medicaid Already Spend More of Their Income on Out-of-Pocket Medical Expenses Than Higher Income Privately-insured People
Source: Ku and Broaddus, 2005, Analyses of 2002 Medical Expenditure Panel Survey
Out-of-Pocket Medical Expenses Already Rising Faster than Income, Especially for Medicaid
Average Annual Growth Rate, 1997-2002
Source: Ku and Broaddus, 2005, Analyses of Medical Expenditure Panel Surveys
Risk adjustment does not work on an individual level.
The “average” amount would not cover the full medical expenses of about 30% of adult women, those with greater health needs.
The “average” amount would provide
more money than is actually used by
about 70% of adult women.
Average Expenditure = $2,119
Women’s Medicaid expenditures in 2002, based on Medical Expenditure Panel Survey