1. CENTERS for MEDICARE & MEDICAID SERVICES Tom Scully CMS Administrator

3. Total CMS budget ~ $429 billion in FY 2003 ($549 billion w/ Medicaid state match) Medicare: FY 2003 ~ $254.8 billion 5.7% average annual growth rate $246.7 billion (FY 2002) to $428.6 billion (FY 2012) Medicaid: FY 2003 ~ $158.7 billion Plus state spending of $120 billion 8.4% spending rate increase over next 10 years Medicare and Medicaid Budget

4. Beneficiaries covered (in millions - September 2002) Total:42.5 Aged:4.5 Blind/Disabled: 7.5 Children:21.5 Adults:9.0 Medicaid Coverage

5. Total new eligibles: 2,902,102 HIFA waivers expanded coverage: 476,750 Pharmacy Plus:555,294 Family Planning: 88,000 Enhanced coverage: 6,703,597 Waiver Coverage

6. Home/Community Based Services Expanded opportunities for Medicaid beneficiaries to live in their homes or in the community rather than in nursing homes, hospitals, or other institutions Total:688,152 AIDS/Tech Dependents 21,843 Disabled/Physically Disabled 24,997 MR/DD259,561 Aged / Disabled381,751 Waiver Coverage

7. Federal matching payments ~ $147 billion Largest source of federal funds to states = 43% of all grants-in-aid. Mandatory Spending Acute Care~80% Long Term Care 12% Medicare ~8% Optional Spending Long Term Care 58% Other Acute Care 31% Prescription Drugs 10% Medicaid Spending (FY 2002)

8. Uninsured Issues Insurance Coverage Rates: 41.2 million uninsured

9. The Uninsured Rate Over Time

10. Uninsured Distribution by Citizenship

11. Uninsured Rates by Age

12. Uninsured Rates by Race

13. Kaiser Commission on Medicaid and the Uninsured 2001

15. Uninsured receive health care Less care than insured people Uninsured average $1253 in medical care Privately insured average $2484 in medical care Uninsured Care

16. Benefits Health insurance reduces mortality rates by 10 to 15 % Better health associated with insurance coverage boosts yearly income 10 to 30 % Least efficient care – after people get sick and need emergency or hospital care Decreasing the Number of Uninsured

17. About $30-40 billion a year in new funding About $1000 per person per year for about 40 million people $31 billion - current spending on uncompensated care $9 billion from President’s Tax Credit Proposal ($89 billion over 10 years) Additional $20-30 billion a year would allow essential insurance coverage for all. Cost of Covering the Uninsured

18. Goal:To Reduce the Number of Uninsured Credit Amounts Adult/child: $1,000/$500 Family Max: $3,000 Income range covered Single: full up to $15,000--phase out at $30,000 Families: full up to $25,000--phase out at $60,000 President’s Tax Credit Proposal

19. Goal:To Reduce the Number of Uninsured “Minimum standards” Individual private insurance market Existing state rules Based on last year’s income as reported to the IRS No change to current law Federal program President’s Tax Credit Proposal

20. CMS – Improving Health Care Long Term Care –Reverse Mortgages Medicare Reform Quality –Nursing Homes –Home Health –Hospitals Medicaid Reform –Secretary Thompson Other Issues