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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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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… 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
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
Health Coverage (and Type) Varies Greatly by Age and Family Income
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
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
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
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
Coverage Trends Over Time – Adults 18-64 Employer Coverage Declines Offset by Increased Public Coverage Source: U.S. Census figures compiled by GBPI
Coverage Trends Over Time Low-Income Kids Far More Likely to be Covered than their Parents Source: U.S. Census figures compiled by GBPI
A Closer Look at Georgia’s Medicaid and PeachCare Programs Illustrates Gaps
Current Eligibility for Medicaid and PeachCare Focused on Children (Poverty = $11,200 for individual, $19,100 for family of three)
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
Optional Medicaid Expansion Under ACA (Poverty = $11,200 for individual, $19,100 for family of three)
Supreme Court Ruling Creates a Wrinkle: Medicaid Expansion Now a State Option Photo Credit. University of British Columbia
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
Medicaid Funding Fails to Keep Pace With Enrollment Growth Since Recession (2008)
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
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
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
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
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 404.420.1324 THANK YOU. Let’s keep in touch. @gabudget www.facebook.com/gabudget