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MCHB Partnership Meeting

MCHB Partnership Meeting. Sara Rosenbaum Harold and Jane Hirsh Professor, Health Law and Policy Chair, Department of Health Policy The George Washington University School of Public Health and Health Services October 17, 2006. Characteristics of the Uninsured, 2004. Age. Income.

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MCHB Partnership Meeting

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  1. MCHB Partnership Meeting Sara Rosenbaum Harold and Jane Hirsh Professor, Health Law and Policy Chair, Department of Health Policy The George Washington University School of Public Health and Health Services October 17, 2006

  2. Characteristics of the Uninsured, 2004 Age Income Work Status Part-Time Workers 13% Children Under 19 20% No Workers 19% 1 or More Full-Time Workers 69% Total = 45.5 million uninsured Note: The federal poverty level was $19,307 for a family of four in 2004. SOURCE: KCMU and Urban Institute analysis of the March 2005 Current Population Survey.

  3. Number of Uninsured Children and Adults, 2000 - 2004 In millions 45.5 M 44.7 M 43.3 M 40.9 M 39.6 M Note: Sums may not equal totals due to rounding. SOURCE: KCMU and Urban Institute estimates based on the March Current Population Surveys, 2001-2005.

  4. Nonelderly Adults Children 6.0 Million* 10.0 Million* 8.5 Million* 6.3 Million* 1.5 Million -0.3 Million Change in Population Change in Uninsured Health Insurance Coverage of the Nonelderly Population, Percentage Point Changes, 2000 – 2004 Employer Sponsored Medicaid Direct Purchase Uninsured *Statistically significant change between 2000 and 2004 (p<.05). Medicaid also includes S-CHIP and other state programs. SOURCE: Urban Institute, 2005.

  5. Cumulative Changes in Health Insurance Premiums, Overall Inflation, and Workers’ Earnings 2000 - 2006 Note: Data on premium increases reflect the cost of health insurance premiums for a family of four. Source: KFF/HRET Survey of Employer-Sponsored Health Benefits, 2001-2006; Bureau of Labor Statistics, Consumer Price Index, U.S. City Average of Annual Inflation (April to April), 2001-2006; Bureau of Labor Statistics, Seasonally Adjusted Data from the Current Employment Statistics Survey (April to April), 2001-2006.

  6. Increases in Health Insurance Premiums Compared to Other Indicators, 1988-2006 3.8% 3.5% *Estimate is statistically different from the previous year shown at p<0.05. Note: Data on premium increases reflect the cost of health insurance premiums for a family of four. Source: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 1999-2006; KPMG Survey of Employer-Sponsored Health Benefits, 1993, 1996; The Health Insurance Association of America (HIAA), 1988, 1989, 1990; Bureau of Labor Statistics, Consumer Price Index (U.S. City Average of Annual Inflation (April to April), 1988-2006; Bureau of Labor Statistics, Seasonally Adjusted Data from the Current Employment Statistics Survey, 1988-2006 (April to April).

  7. Average AnnualPremiums for Covered Workers, by Plan Type, 2006 All Plans $4,242 $11,480 HMO $4,049* $11,278 PPO $4,385* $11,765 POS $4,168 $11,107 HDHP/SO $3,405* $9,484* * Estimate of total premium is statistically different from All Plans estimate by coverage type at p<.05. Note: Family coverage is defined as health coverage for a family of four. Source: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2006.

  8. Percentage of All Workers Covered by TheirEmployers’ Health Benefits, in Firms Both Offering and Not Offering Health Benefits, 1999-2006* * Tests found no statistical difference from estimate for the previous year shown at p<.05. Source: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 1999-2006.

  9. Medicaid’s Role for Selected Populations Percent with Medicaid Coverage: Families Aged & Disabled Note: “Poor” is defined as living below the federal poverty level, which was $19,307 for a family of four in 2004. SOURCE: KCMU, KFF, and Urban Institute estimates; Birth data: NGA, MCH Update.

  10. Medicaid Enrollees are Poorer and Sicker Than The Privately Insured Percent of Enrolled Adults: Low-Income and Privately Insured Medicaid Poor Health Conditions that limit work Fair or Poor Health SOURCE: Coughlin et. al, 2004 based on a 2002 NSAF analysis for KCMU.

  11. Inflation-Adjusted Federal Spending per Uninsured Person vs. the Number of Uninsured, 2001-2004 Uninsured in Millions Federal Safety Net Spending per Uninsured Person in 2004 Dollars

  12. The Deficit Reduction Act of 2005 • Policy environment: no growth and faltering Medicaid enrollment • “20/20 hindsight” • Documentation of citizenship/legal status • 1-3 million citizens and legal residents • Benefit flexibility • Medicaid as a market purchaser • EPSDT supplement • Premiums and Cost sharing • “Enforceability” • Targeted case management • Medicaid’s relationship to the public health and human service infrastructure

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