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www.healthpolicy.ucla.edu Shana Alex Lavarreda, PhD, MPP Sacramento, CA 2/10/2010 The Uninsured and National Health Care Reform
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46 Million Adults and Children are Uninsured in the United States Notes: Numbers may not add to 100% due to rounding. Source: Urban Institute and Kaiser Commission on Medicaid and the Uninsured estimates based on the Census Bureau's March 2008 and 2009 Current Population Survey (CPS: Annual Social and Economic Supplements). www.statehealthfacts.org
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Health Insurance Coverage During Last 12 Months Among Non-Elderly Persons, Ages 0-64, California, 2007 Notes: Numbers may not add to 100% due to rounding. "Other All Year" includes other government-sponsored programs that are not Medi-Cal, as well as any combinations of insurance over the last 12 months during which the person was never uninsured. Source: 2007 California Health Interview Survey
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Health Insurance Coverage During Last 12 Months Among Children, Ages 0-18, California, 2001-2007 Notes: Numbers may not add to 100% due to rounding. "Other All Year" includes other government-sponsored programs that are not Medi-Cal, as well as any combinations of insurance over the last 12 months during which the person was never uninsured. * Data is significantly different from 2007 at the 95% confidence level. Sources: 2001, 2003, 2005 and 2007 California Health Interview Surveys
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Health Insurance Coverage During Last 12 Months Among Adults, Ages 19-64, California, 2001-2007 Notes: Numbers may not add to 100% due to rounding. "Other All Year" includes other government-sponsored programs that are not Medi-Cal, as well as any combinations of insurance over the last 12 months during which the person was never uninsured. * Data is significantly different from 2007 at the 95% confidence level. Sources: 2001, 2003, 2005 and 2007 California Health Interview Surveys
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Household Income as Percent of the Federal Poverty Level Among Non-Elderly Persons Uninsured All or Part Year, Ages 0-64, California, 2007 Notes: Numbers may not add to 100% due to rounding. The 2007 Federal Poverty Level was $10,210 for one person, $13,690 for a two-person family and $17,170 for a three- person family. Source: 2007 California Health Interview Survey
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Family Work Status Among Non-Elderly Persons Uninsured All or Part of the Last 12 Months, Ages 0-64, California, 2007 Note: Numbers may not add to 100% due to rounding. Source: 2007 California Health Interview Survey
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Citizenship and Immigration Status Among Non-Elderly Persons Uninsured All or Part Year, Ages 0-64, California, 2007 Note: Numbers may not add to 100% due to rounding. Source: 2007 California Health Interview Survey
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Percent Uninsured All or Part Year by County, Ages 0-64, California, 2007 Note: Differences in rates between counties may not be statistically significant. Source: 2007 California Health Interview Survey
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If Nothing Changes – Outlook for 2010 and Beyond Implementation of new initiatives from ARRA Quality (value based purchasing) Electronic health records and e-prescribing Chronic care management Strategies to improve access and to address low-income uninsured Budget and state fiscal pressures Medicaid spending and enrollment trending up Economy impacting state revenues Mid-year budget actions Healthy Families had enrollment frozen for six weeks this year. 2010 likely to be a difficult year
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Eligibility for Medi-Cal and Healthy Families in California, October 2009 300% FPG Eligible for AIM Eligible for Healthy Families IF < 2yrs & Mother in AIM Not Eligible 250% FPG Healthy Families Eligible Not Eligible 200% FPG Healthy Families Eligibility Authorized not Imple- mented 133% FPG Medi-Cal Eligible 100% FPG Medi-Cal Eligible 75% FPG Medi-Cal Eligible Pregnant Women Ages 0 – 1 Ages 1 – 5 Ages 6 – 18 Ages 19 – 64, with Children Ages 19-20, Medically Indigent/ Needy Disabled and Aged All Other Adults ChildrenAdults
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Eligibility of Currently Uninsured Children and Adults for Public Insurance Programs, Ages 0-64, California, 2007 Note: Numbers may not add to 100% due to rounding. Note: Eligibility for Healthy Kids programs is determined by meeting the eligibility criteria, and disregards whether there is room in the program to accept new enrollees. Source: 2007 California Health Interview Survey
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Changes Proposed in National Health Care Reform The House and Senate bills would make two key changes: Expand Medicaid eligibility to include qualified uninsured adults and children with household incomes up to 133% FPL (Senate) or 150% FPL (House). Provide public subsidies to enable qualified uninsured adults and children with household incomes from 134%/150% - 400% FPL to purchase insurance CHIP might be eliminated in favor of moving all eligible families into a health insurance exchange “Public option” within the exchange(s) could be expansion of current CHIP program in every state Other options: A national public option, more like “Medicare for All” (House) State-based non-profit, co-op plans (Senate) OPM managed, national not-for-profit private plans (Senate)
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Eligibility for Health Insurance Expansions Under Proposed National Health Care Reform, Ages 0-64, California, 2007 SOURCE: Lavarreda, SA and Brown, ER (2009). National Health Care Reform Will Help 4 Million Uninsured Adults and Children in California. Fact Sheet, UCLA Center for Health Policy Research, October.
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www.healthpolicy.ucla.edu Thank You – and I’m Here to Help! Shana Alex Lavarreda, PhD, MPP Director of Health Insurance Studies and Research Scientist shana@ucla.edu, (310) 794-2261 www.chis.ucla.edu www.statehealthfacts.org
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