How Medicaid Expansion Would Benefit Florida. A Guide for Understanding Florida s Medicaid Program and How to Improve It

Transcription

1 How Medicaid Expansion Would Benefit Florida A Guide for Understanding Florida s Medicaid Program and How to Improve It

2 Page 2

3 Table of Contents Section 1 : Understanding Florida s Medicaid Program... 4 Who Gets Medicaid in Florida?...5 Who Qualifies for Medicaid in Florida?...6 How Restrictive is Florida s Medicaid Program?...7 When the Economy is Down, Medicaid Enrollment Increases...8 Medicaid Controls Costs Better...9 Projected Increase in State Medicaid Spending for State Fiscal Year Section 2 : Florida s Opportunity to Close The Coverage Gap...11 Expansion Would Loosen Restrictions on Eligibility What is the Coverage Gap in Florida? Local Communities Stand to Benefit Coverage for Workers in Key Sectors Majorities and Minorities Florida s Veterans and Medicaid Expansion Drastic Difference Section 3 : Economic and Other Benefits of Closing the Coverage Gap Closing the Coverage Gap is a Great Deal For Florida Booster Shot to the Economy Key Sources for Savings Health Insurance Matters Section 4 : We Should Not Delay We Can t Afford to Wait Prescription for Access Florida Can Change Course About the Florida Policy Institute Page 3

4 Section 1 Understanding Florida s Medicaid Program Page 4

5 Who Gets Medicaid in Florida? Nearly 2 out of every 10 people in Florida More than one in three poor* adults in Florida Four out of every five poor* kids in Florida *Poor is defined as families earning <100% of the Federal Poverty Level. Source: Kaiser Family Foundation Page 5

6 Who Qualifies for Medicaid in Florida? Several groups are covered and each group has different thresholds. (Eligibility is determined by measuring income as a percentage of Federal Poverty Levels) Children (Ages 0-1) Children (Ages 1-5) Children (Ages 6-18) Pregnant Women Disabled Adults Parents of Dependent Children Childless Adults 30% 0% 88% 0% 50% 100% 150% 200% 250% Source: Medicaid.gov 140% 133% 191% 206% $49,955 $33,950 $32,253 $46,318 $21,340 $7,275 Dollar amounts for income thresholds of a family of four Page 6

7 How Restrictive is Florida s Medicaid Program? 43 rd Only 7 states make it harder for working parents to get Medicaid. If a family of four lives in Florida and has an annual income above $7,275 The parents would be ineligible for Medicaid. Source: Medicaid.gov Page 7

8 When the Economy is Down, Medicaid Enrollment Increases Between 2008 and 2009: The number of jobs in Florida decreased from 8.4 million to 8.1 million The number of Floridians covered by employer-sponsored health insurance decreased from 9.4 million to 8.9 million 300,000 people 500,000 people 330,000 jobs 500,000 people Florida s Medicaid/ CHIP enrollment increased from 2.3 million to 2.6 million The number of uninsured people in Florida increased from 3.5 million to 4 million Sources: US Department of Labor, Bureau of Labor Statistics, US Census Bureau, and Agency for Health Care Administration Page 8

9 Medicaid Controls Costs Better 8% 7% 6% Between , the growth in per-person cost was much lower in Medicaid than in the private insurance market. 7.7% 5% 4% 3% 4.6% 2% 1% 0% Medicaid Cost Source: Center on Budget and Policy Priorities Analysis Private Insurance Page 9

10 Projected Increase in State Medicaid Spending for State Fiscal Year % 7% 6% 5% Page 10 4% 3% 2% 1% 0% 4.4% 6.8% Medicaid Expansion States Non Expansion States Source: Center on Budget and Policy Priorities Note: Projected increase in state Medicaid spending for state fiscal year 2015

11 Section 2 Florida s Opportunity to Close The Coverage Gap Page 11

12 Expansion Would Loosen Restrictions on Eligibility Currently Eligible Newly Eligible Disabled Adults 88% 138% Working Parents 30% 138% Childless Adults 138% 0% 30% 60% 90% 120% 150% Income as Percentage of Federal Poverty Level Page 12

13 What is the Coverage Gap in Florida? 567,000 people in Florida fall into the coverage gap. Current FL Medicaid Program Health Insurance Marketplace Subsidies Under Florida s current Medicaid program, working parents must have incomes below 30 percent of the Federal Poverty Level (FPL) to be eligible for Medicaid. *$7,275 represents 30% of the Federal Poverty Level for a family of four. *$24,250 represents 100% of FPL for a family of four.this is the lower threshold for receiving subsidies to buy healthcare in the marketplace. Childless adults are not eligible for Medicaid no matter how poor they are, unless they are elderly, disabled, or pregnant. $7,275* $24,250* Sources: Medicaid.gov, US Department of Health and Human Services, and the Kaiser Family Foundation. Page 13

14 Local Communities Stand to Benefit Percentage of uninsured people who could gain coverage 22.3% 45.0% Source: U.S Census Bureau, FPI Analysis of United States Census Bureau Data.[i]; County-by-county data provided upon request Page 14

15 Coverage for Workers in Key Sectors Workers in 10 of the state's top largest employment sectors have the most to gain under an expanded Medicaid program. RESTAURANTS & OTHER FOOD SERVICES CONSTRUCTION LANDSCAPING SERVICES SERVICES TO BUILDINGS & DWELLINGS DEPARTMENT & DISCOUNT STORES GROCERY STORES AGRICULTURE PRIVATE HOUSEHOLDS HOTELS / MOTELS 25,430 24,230 21,790 21,250 21,070 18,790 13,570 87,490 95,360 CHILD DAY CARE SERVICES 10, Page 15 Source: FPI analysis of the U.S Census Bureau Data using IPUMS. American Community Survey 2014.

16 Majorities and Minorities Minorities make up almost two thirds of Florida s uninsured population, although they make up less than half of the general population. Minorities represent 64.2% of Florida s uninsured population. Minorities represent 44.4% of Florida s total population. Source: FPI analysis of the U.S Census Bureau Data using IPUMS. American Community Survey Page 16

17 Florida s Veterans and Medicaid Expansion 41,200 uninsured veterans 13,400 uninsured spouses of veterans Source: Haley, Jennifer, and Genevieve M Kinney. Uninsured Veterans and Family Members: State and National Estimates of Expanded Medicaid Eligibility Under the ACA. Page 17

18 Drastic Difference 40% States that closed their coverage gaps have seen the number of adults without health coverage drop by 37.7 percent. Compare that with a just 9 percent drop in states like Florida that did not close the coverage gap. Percent reduction in uninsured nonelderly adults 30% 37.7% 20% Page 18 10% 0% Closed the gap Did not Source: Urban Institute survey results released July 10, %

19 Section 3 Economic and Other Benefits of Closing the Coverage Gap Page 19

20 Closing the Coverage Gap is a Great Deal For Florida The federal government will cover the vast majority of the costs of closing the coverage gap. Other public health programs require far more state funds. 100% 100% 90% 80% 72.47% 60% 60.67% 40% 39.33% 27.53% 20% 10% 0% Federal Florida Federal Florida Federal Florida Federal Florida Current Medicaid Kidcare 0% Closing the coverage gap under ACA 2016 Closing the coverage gap beyond 2020 Page 20 Source: Federal Register:

21 Booster Shot to the Economy New Federal resources would bring new jobs and revenues to the sta + New Jobs 58,400 $16.7 Billion in new federal funding ( ) $ New Tax Revenues $1.8 Billion Source: Hodges, Alan W. and Mohammad Rahmani The Economic Impact of the Pati Protection and Affordable Care Act in Florida. Page 21

22 Key Sources for Savings State Michigan Kentucky Arkansas % Decrease in uncompensated care 85% decrease* *in the Detroit area 59.7% decrease 56.4% decrease State savings due to additional federal funding $35 million $33.3 million $68 million Mental health savings $190 million $21 million $7.1 million Sources: Bachrach, Deborah et al., States Expanding Medicaid See Significant Budget Savings and Revenue Gains. Early Data Shows Consistent Economic Benefits Across Expansion States and Bachrach, Deborah et al., The Impact of Medicaid Expansion on Uncompensated Care Costs: Early Results and Policy Implications for States. Page 22

23 Health Insurance Matters Affordable health care delivers great value for individuals and communities. Improves Financial Health Controls Costs Reduces Death Rate Page 23

24 Section 4 We Should Not Delay Page 24

25 We Can t Afford to Wait $16.7 billion* in federal funds could be injected into Florida s economy $1.8 billion* in new tax revenues Support for 58,000* new jobs guaranteed budget savings from using federal funds, rather than state dollars, for existing healthcare programs such as mental health services and uncompensated care costs. *These are cumulative total estimates for the years , if Florida were to close the coverage gap by expanding Medicaid. January 1, 2014 Florida could have closed the coverage gap on January 1, The state is losing money every day that it fails to do so. Sources: Hodges, Alan W. and Mohammad Rahmani Economic Impacts of the Patient Protection and Affordable Care Act in Florida. and Bachrach, Deborah et al Medicaid expansion States See Significant Budget Savings and Revenue Gains. Page 25

26 Prescription for Access Prescription for Access Three out of five doctors in Florida are accepting new Medicaid Patients. Page 26 Source: Galewitz, Phil. Nearly a Third of Doctors Won t See New Medicaid Patients Kaiser Health News, 6 August

27 Florida Can Change Course If Congress lowers the enhanced federal match rate (of 90%) for covering low-income adults, Florida can exit the new program Page 27

28 About the Florida Policy Institute This guidebook was produced by staff of The Florida Policy Institute. The Florida Policy Institute is an independent, nonpartisan and nonprofit organization dedicated to promoting widespread prosperity through timely, thoughtful and objective analysis of state policy issues affecting economic opportunity. The Institute provides analysis of state budget and revenue trends and proposes common-sense policy options with the aim of encouraging broad public education, discussion, and informed action. The Institute advances fiscal policies that expand economic opportunity for all Florida residents. Our goal is to be an accurate, trusted source of information for policymakers, advocates, the media, and the public at large. For more information, contact: Joseph F. Pennisi Executive Director Page 28