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Health Coverage in Georgia and the Impact of Expanding Coverage Through Medicaid - PowerPoint PPT Presentation


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GAMHPAC Meeting October 16, 2012. Health Coverage in Georgia and the Impact of Expanding Coverage Through Medicaid. Timothy Sweeney Director of Health tsweeney@gbpi.org. Georgia has…. t he 5th largest number of uninsured individuals in the nation at nearly 1.9 million.

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Presentation Transcript
slide1

GAMHPAC

Meeting

October 16, 2012

Health Coverage in Georgia and the Impact of Expanding Coverage Through Medicaid

Timothy Sweeney

Director of Health

tsweeney@gbpi.org

slide2

Georgia has…

the 5th largest number of uninsured individualsin the nation at nearly 1.9 million

an uninsured population that grew by 700,000 in the last 10 years (60% increase)

Photo Credit: Excelencia in Education www.edexcelencia.org

slide4

Employer-sponsored Insurance

Dominant method of private health coverage where employers and workers share the costs

52.4%

5.8 million

8.0%

782,600

Individual Insurance

More costly method of private health insurance

Medicare

Federally funded public program, serves Americans over 65

11.0%

1.1 million

Medicaid

State and federally funded program, serves low-income kids, pregnant women, individuals with disabilities, very low-income adults

13.7%

1.3 million

19.6%

1.9 million

No Insurance Coverage

slide6

Public Programs Reduce Uninsured for Children and Elderly (2011)

29%

$2.6 billion

71%

$5.2 billion

Source: 2011 American Community Survey data compiled by GBPI

slide7

Working Age Adults Depend on Private Coverage More than other Age Groups

Low-Income Adults Often Uninsured

Family Income as a Percent of Poverty, 2011

Source: 2011 American Community Survey data compiled by GBPI

slide8

Health Coverage for Children and Adults

Low-Income Kids Far More Likely to be Covered than Adults at Same Income

Family Income as a Percent of Poverty, 2010

Source: U.S. Census figures compiled by Custer & Ketsche, PhDs, GSU Center for Health Services Research

slide9

Coverage Trends in Last Decade

  • Employer Coverage is Declining (in GA and US)
  • Key issue for small business & low-wage workers

Public Programs Maintained Coverage for Kids & Elderly

Adult Uninsured Rates Climbing

Photo Credit. University of British Columbia

slide10

Coverage Trends Over Time – Adults 18-64

Employer Coverage Declines Offset by Increased Public Coverage

Source: U.S. Census figures compiled by GBPI

slide11

Coverage Trends Over Time

Low-Income Kids Far More Likely to be Covered than their Parents

Source: U.S. Census figures compiled by GBPI

slide13

Current Eligibility for Medicaid and PeachCare Focused on Children

(Poverty = $11,200 for individual, $19,100 for family of three)

slide14

ACA Expands Medicaid to Fill Coverage Gaps

  • Expands Eligibility to Adults up to 138% of Poverty Level
  • About $15k for individual; $26k for family of three
  • Other Key Changes:
  • Higher Primary Care Payment Rates
  • 12-Month Eligibility Determinations
  • Federal Funding for Computer Upgrades
  • Federal Funds Pay 100% of the Costs for 3 Years
  • Federal funds pay at least 90% in the long term

Photo Credit. University of British Columbia

slide15

Optional Medicaid Expansion Under ACA

(Poverty = $11,200 for individual, $19,100 for family of three)

slide16

Supreme Court Ruling Creates a Wrinkle:

Medicaid Expansion Now a State Option

Photo Credit. University of British Columbia

slide17

Examining the Decision in Georgia

Election Year Uncertainty Muddles Issue

Delay Decision Past November

  • Uncertainty Surrounding Existing Medicaid Program
  • Ongoing “redesign” efforts, program underfunded
  • Structural State Budget Deficit Complicates Issue
  • State Revenue among lowest in nation (50th per-capita)
  • State is underfunding current program
  • Budgetary costs are easier to quantify than savings,
  • economic benefits, or social benefits
slide19

A Closer Look At State’s Numbers

  • Predicts 600,000 Newly Covered Georgians
  • Includes nearly 100,000 kids already eligible
  • Represents one-third of currently uncovered Georgians
  • State Projects $4.5 B / 10 yrs
  • Includes $2 B not dependent on expansion
  • Does not count savings in state programs serving uninsured
  • Expansion costs amount to <2% state spending over 10 yrs
  • Assumes New Enrollees to be 17% More Expensive
  • Problematic assumption, could inflate forecast by >$300 million / 10 years

Photo Credit. University of British Columbia

slide20

Federal Funds Cover Bulk of Expansion Costs

10-Year Coverage Related Costs – State Share ≈ 7.5 percent of total

New State spending ≈ 1-2 Percent of Total State Budget

Source: State Cost Estimates

slide21

Economic Impact of Expansion in Georgia

  • Dramatic Impact in Short Term (2014-16)
  • No state costs for newly eligible
  • More than $7.4 B in new federal funds
  • New Spending Benefits Providers, Overall System
  • Could reduce uncompensated care by > $2 B / yr
  • Economic Benefits & State Savings Will Offset Some Costs
  • New economic activity will generate some state revenues
  • State will save on programs serving uninsured Georgians
  • Reduced uncompensated care will benefit privately insured
  • and employers who sponsor coverage
slide22

Mental Health Services Part of Expansion

  • Medicaid would cover mental health services
  • For new enrollees
  • Federal funds could ease burden on state
  • and local governments

Projecting Savings is Difficult; Need State Cooperation

  • Broad Implications of Expanded Access to MH/SA Services
  • Increased coverage of adults increases access to care
  • State will save on programs serving uninsured Georgians
  • Reduced uncompensated care will benefit privately insured
  • and employers who sponsor coverage
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About the Georgia Budget & Policy Institute

GBPI seeks to build a more prosperous Georgia. We rigorously analyze budget and tax policies and provide education to inspire informed debate and responsible decision-making, advancing our vision of a state in which economic opportunity and well-being are shared among all. GBPI is an independent, nonpartisan nonprofit founded in 2004.

www.gbpi.org

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