Comparing New York and Massachusetts: Implications for Reform Elise Hubert United Hospital Fund June 9, 2006

2 14% 70% New York StateMassachusetts <100% FPL Distribution of Population by Poverty Level, New York State vs. Massachusetts, Source: Urban Institute and Kaiser Commission on Medicaid and the Uninsured estimates based on the Census Bureau's March 2004 and 2005 Current Population Survey (CPS: Annual Social and Economic Supplements). Kaiser State Health Facts, Note: Data are for 2003 and 2004 and include persons of all ages. Low-income is defined here as no greater than 200% of the federal poverty level. The federal poverty level for a family of three was $14,680 in 2003 and $15,067 in Numbers may not add to 100% due to rounding. 6.4 million people 16% 20% 19% 62% 19.0 million people New York has a larger share of low-income residents than Massachusetts.

3 61% 19% 17% 68% 13% New York StateMassachusetts Employer- Sponsored Employer- Sponsored Distribution of Health Insurance Coverage among the Non-elderly, New York State vs. Massachusetts, Source: Urban Institute and Kaiser Commission on Medicaid and the Uninsured estimates based on the Census Bureau's March 2004 and 2005 Current Population Survey (CPS: Annual Social and Economic Supplements). Kaiser State Health Facts, Note: Data are for 2003 and 2004 and include all persons below age 65. Numbers may not add to 100% due to rounding million non-elderly5.6 million non-elderly 4% 5% 14% New York has a lower rate of employer-sponsored coverage and higher uninsured rate than Massachusetts.

4 36% 37% New York StateMassachusetts <100% FPL Percent of Total Non-elderly Uninsured by Income, New York State vs. Massachusetts, Source: Urban Institute and Kaiser Commission on Medicaid and the Uninsured estimates based on the Census Bureau's March 2004 and 2005 Current Population Survey (CPS: Annual Social and Economic Supplements). Kaiser State Health Facts, Note: Data are for 2003 and 2004 and include all persons below age 65. Low-income is defined here as no greater than 200% of the federal poverty level. The federal poverty level for a family of three was $14,680 in 2003 and $15,067 in Numbers may not add to 100% due to rounding. 2.8 million uninsured710,000 uninsured 26% 29% 43% Low-income individuals represent a greater share of the uninsured in New York than in Massachusetts.

5 45%55% 23% 77% New York StateMassachusetts Eligible but Uninsured Eligible but Uninsured Share of Uninsured Eligible for Public Health Insurance, New York State vs. Massachusetts, Source: New York eligible but uninsured data are from March 2004 Current Population Survey, Annual Social and Economic Supplement; tabulations prepared for the United Hospital Fund by the Urban Institute. Massachusetts eligible but uninsured data taken from Oakes, M. “Eligible but Uninsured: Challenges to Getting and Keeping MassHealth,” Massachusetts Medicaid Policy Institute, April Note: New York data are for 2003, Massachusetts data are for Massachusetts eligible but uninsured rate is based on a State estimate of 460,000 total uninsured in MA. New York eligible but uninsured rate is based on the CPS estimate of 2.9 million uninsured in NY. Numbers may not add to 100% due to rounding. Nearly half of all uninsured New Yorkers are already eligible for a public program compared with less than one-quarter of the uninsured in Massachusetts.

6 New York vs. Massachusetts  Similarities: –Assessments on insurance to fund uncompensated care. –Strong safety net system. –Insurance market protections for consumers: Guaranteed issue Community rating Limits on medical underwriting