1. Health Care and the Economic Slowdown Barbara Coulter Edwards National Association of State Medicaid Directors February 15, 2008

2. Medicaid By the Numbers 50 million covered lives 70% of spending is for the elderly and people of all ages with chronic or disabling conditions 40% of spending is for people already covered by Medicare 23% of state budgets 60/40 is average federal/state funding split

3. Economy slows Medicaid grows Budget deficit Cuts to Medicaid: 60% fmap means $2.40 cut in Medicaid to save $1 in state GRF (provider rates, eligibility, benefits) Loss of federal + state funds to local economies More uninsured

4. Economy slows Medicaid grows Budget deficit Cuts to Medicaid: 60% fmap means $2.40 cut in Medicaid to save $1 in state GRF (provider rates, eligibility, benefits) Loss of federal + state funds to local economies More uninsured Federal Cuts Federal stimulus: FMAP

5. State Actions to Contain Medicaid Costs FY 2002 – FY 2006 SOURCE: Vernon Smith, Kathleen Gifford, Eileen Ellis, Amy Wiles, Robin Rudowitz and Molly OMalley, Medicaid Budgets, Spending and Policy Initiatives in State Fiscal Years 2005 and 2006: Results from a 50 State Survey, Kaiser Commission on Medicaid and the Uninsured, October 2005. http://www.kff.org/medicaid/7392.cfm http://www.kff.org/medicaid/7392.cfm Number of States