“Medicaid Made Simple” in West Virginia House Government Organization Committee February 2, 2012 Renate Pore, Health Policy Director WV Center on Budget.

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Presentation transcript:

“Medicaid Made Simple” in West Virginia House Government Organization Committee February 2, 2012 Renate Pore, Health Policy Director WV Center on Budget & Policy WV For Affordable Health Care

“ Medicaid Made Simple” helps us understand: Who Benefits from the Medicaid Program; Serves a Dual Purpose as Health AND Long-Term Care Program; Identifies How Much Medicaid Costs and Who Pays; Understand Medicaid’s Impact on Jobs and the State Economy; Recognizes Future Role of Medicaid in Health Care Reform

KIDS: The Basics Eligibility Guidelines are based on both Age and Income as a Percent of the Federal Poverty Level (FPL) Source: WV Bureau of Medical Services, June 2011 AGEINCOME (% of FPL) Newborns to 1 year old150% 1 year old to 6 years old133% 6 years old to 21 years old100% Children’s Health Insurance Program (CHIP) 300% 50% of all WV Children Are Covered by Medicaid Program (205,000)

EPSDT/Health Check Physical Social Emotional Cognitive Oral Health Access MEDICAID PROVIDES BASIC CARE

MEDICAID PROVIDES BASIC CARE TO PREGNANT WOMEN More than half of 20,000 births are paid by Medicaid annually. Source: WV Bureau for Medical Services, 2011

SENIORS RECEIVE CRITICAL SERVICES 80,000 Seniors Over Age 65 Receive Some Benefit 50,000 West Virginia Seniors Receive Full Benefits 30,000 West Virginia Seniors Receive Low Income Assistance on Medicare Premiums Source: MACPAC Report to the Congress on Medicaid and CHIP, March 2011

NURSING HOMES DEPENDENT ON MEDICAID SPENDING

MEDICAID HELPS PEOPLE WITH PHYSICAL AND MENTAL DISABILITIES 110,000 Blind, Aged & Disabled West Virginians Receive Benefits 60,000 age on SSI unable to work 50,000 over age 65 on Social Security

MEDICAID BENEFITS AND EXPENDITURES 51% of All Medicaid Beneficiaries are Children, But Account for 21% of Cost, conversely; 27% of All Medicaid Beneficiaries are Blind and Disabled, But Account for 49% of Cost

MEDICAID SPENDS $2.5 BILLION IN STATE AND LOCAL ECONOMY

MEDICAID SPENDING IN LINE WITH OTHER HEALTH SPENDING Source: Office of the Actuary, Centers for Medicaid and Medicare, December, 2011 Average CostsWest VirginiaUnited States Per Capita$7,667$6,815 Medicare$9,333$10,365 Medicaid$6,886$6,826

MEDICAID PAID FOR MOSTLY BY FEDERAL GOVERNMENT Federal/State Partnership Match varies from year to year Most years average 75/25% Match increased in 2010/11 Expected to decrease to 72-73% 1% = $29 million

MEDICAID SPENDING IN 2010 IS LOWER THAN IN 2005 (ADJUSTED)

FEDS SPENDS MORE WHILE STATE PAYS SAME AS PERCENT OF GDP

Growth Rates of Major Public Programs Between National Association of State Budget Officers, “State Expenditure Reports”

MEDICAID SPENDING CREATES THOUSANDS OF JOBS 112,000 workers in Health Care Sector; $100 Million in Federal Spending Creates 1,900 jobs; $100 Million in Federal Spending Creates $64 Million in Wages; $100 Million in Federal spending Generates $183 Million in Increased Business Activity Source: WVCBP analysis using Families USA data from “A Shot in the Arm for West Virginia; Increasing Health Coverage for Working Families” January 2009

MEDICAID PLAYS CRUCIAL ROLE IN HEALTH CARE REFORM Expands Medicaid to West Virginians earning below 138% of FPL ($25,000/family of 3); Anticipate about 120,000 West Virginians will be eligible; Federal Government Will Pay 100% for first 3 years; Federal Share Declines to 90%; Average Federal Share Until 2010 is 96%

WHAT HEALTH CARE REFORM WILL MEAN TO WEST VIRGINIA? Families Gain Economic Security and Peace of Mind; Reduces Charity Care; Reduces Cost Shift; New Federal Dollars will Create Jobs & increase Economic Activity.

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