The Health Care System: What it means on the ground

1. The Health Care System: What it means on the ground Alliance for Health Reform Kaiser Commission on Medicaid and the Uninsured February 22, 2010 Gwen O’Shea ,Health & Welfare Council of Long Island

2. Health Care in New York • NY is nearly the highest health spender per capita than any other state in the nation ($126 billion), but: • 18% of adult New Yorkers are uninsured • NY rarely achieves top health outcomes or statistics • Ranks 22nd in a national study of health system performance • 2.5 million uninsured New Yorkers (13% of the population) • 5.2 million New Yorkers uninsured during the year (1/3 adults) • Uninsured more likely to be: • Adults, 2.1 million (18%) • Poorer, 49% of uninsured adults are below 200% FPL • Immigrants, 30% of uninsured adults are non-citizens • Downstate

3. What is the current Environment like RIGHT NOW? • TODAY 48 families will begin the foreclosure process on their homes • in the next HOUR 6.4 private sector jobs will disappear • In 2008, the US GMP grew +0.9%, L.I. GMP shrunk -0.1% • In 2009, US GMP shrunk -2.1%, LI GMP shrunk -3.2% • Over the past decade LI salaries have eroded: 7.5% against the national average (4.9% gain nationally, -2.6% on LI) Information provided by the 2010 Long Island Index

4. What is the current environment like? (continued) • LI is losing high paying manufacturing and finance jobs and replacing them with low-paying jobs in retail. • 21% of households spend more than 50% of their income on housing • btw. 2002-2007; poverty increased by 22% on LI • Food Stamp utilization increased by 33% Information provided by the 2010 Long Island Index

5. Why are so many uninsured? • Costs going up • Job-based coverage going down • Significant increase in unemployment • Navigating the Public Health Insurance System is extremely difficult

6. The Math of Maintaining Coverage Families USA, “Premiums vs. Paychecks: A Growing Burden for New York’s Families.” October 2008.

7. New York, like rest of nation, is losing employer coverage Source: Unheard Third 2002-2009 and Community Service Society

8. What are the options? • Private out of pocket insurance • COBRA • Public Health Insurance • No Coverage The likely option today?

9. No health Coverage • No Preventive Care • No medical home • Lack of productivity for children(25% more likely to do poorly in school without coverage) • Stigma • More costly for the individual, the health care institution, society overall

10. Why We Need Health Reform(State level) • Affordability issues for consumers/patients • Individual mandates and adverse selection • Employer Mandates (aka “Pay or Play”) & ERISA • Public expansions and substitution of coverage and “crowd-out” • Push for deregulation • Erosion of comprehensive benefits v. unnecessarily prescriptive government mandates on the industry • Immigrant coverage www.hcfany.org

11. Why We Need National Health Care Reform • President Obama’s 8 Principles • Families financial health; • Affordable (control costs); • Aim for universality; • Portability; • Guarantee choice; • Prevention/wellness; • Patient Safety/Quality of Care; • Long-term Financial Stability

12. Extension of FMAP is critical • On February 4, Senators Jay Rockefeller (D-WV) and Majority Leader Harry Reid (D-NV) introduced legislation (S. 3000) to extend the Federal Medical Assistance Percentage (FMAP) through June 30, 2011 • Maintains continuity of care, services, job and stabilizes the economy