2017 fact book - texas health and human services · 2017-02-10 · 4 2017 texas hhs fact book i —...
TRANSCRIPT
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BOO
KFA
CT
2017 Texas HHS Fact Book 1
I. Budget ..............................................................3
II. Population .......................................................6
III. Programs .......................................................24
Table of Contents
For Additional Information Please Contact
Texas Health and Human Services CommissionGovernment and Stakeholder Relations
(512) [email protected]
Texas Health and Human Services Website:www.hhs.texas,gov
2 2017 Texas HHS Fact Book
2017 Texas HHS Fact Book 3
I — BudgetA. State Budget, State Fiscal Year (SFY) 2017 ............................................4
B. HHS Budget Requests, By Funding Sources, SFYs 2018-2019 ......4
C. HHS Agencies Budget Requests, By Funding Sources, SFYs 2018-2019 ......5
4 2017 Texas HHS Fact Book
I — Budget
A. State Budget, State Fiscal Year (SFY) 2017 (in millions)
Note: Figures include employee benefits. Figures include the assumption of a supplemental appropriation for FY 2017 for the HHS agencies.
Source: January 2017, Legislative Budget Estimates. House Bill 1 (HB1). Legislative Budget Board.
Notes: Totals may not add up due to rounding. Amounts include exceptional items as of September, 2016. With the consolidation of HHS system agencies required by Sunset
legislation passed by the 84th Legislature, the transformed Texas Health and Human Services system consists of three agencies in the 2018-19 biennium, the Texas Health and Human Services Commission, Texas Department of State Health Services, and Texas Department of Family and Protective Services.
Source: Agency FY2018-2019 Legislative Appropriations Requests (LARs).
B. HHS Budget Requests, By Funding Sources, SFYs 2018-2019 (in millions)
State Federal & Other Total
SFY 2018
dollars $18,155.4 $24,191.7 $42,347.2
percents 43% 57% 100%
SFY 2019
dollars $19,322.6 $25,702.3 $45,025.0
percents 43% 57% 100%
SFY 2018-2019
dollars $37,478.0 $49,894.0 $87,372.2
percents 43% 57% 100%
Health & Human Services
All Other Government
Functions
SFY 2017 State
Budget
General Revenue
dollars $17,338.9 $36,731.7 $54,070.6
percents 32% 68% 100%
General Revenue-Dedicated
dollars $584.1 $3,404.6 $3,988.7
percents 15% 85% 100%
All Funds
dollars $41,299.0 $67,288.7 $108,587.7
percents 38% 62% 100%
2017 Texas HHS Fact Book 5
C. HHS Agencies Budget Requests, By Funding Sources, SFYs 2018-2019 (dollars in millions)
Agency GR /GRD
Federal & Other Total FTEs
SFY 2018
HHSC $16,594.1 $22,912.8 $39,506.9 41,721
DSHS $368.0 $471.7 $839.8 3,295
DFPS $1,193.3 $807.2 $2,000.5 13,753
TOTAL $18,155.4 $24,191.7 $42,347.2 58,768
SFY 2019
HHSC $17,735.5 $24,414.9 $42,150.5 41,883
DSHS $347.2 $469.2 $816.4 3,295
DFPS $1,239.9 $818.1 $2,058.1 13,872
TOTAL $19,322.6 $25,702.3 $45,025.0 59,050
I — Budget
Notes: Totals may not add up due to rounding. Amounts include exceptional items as of September, 2016.
With the consolidation of HHS system agencies required by Sunset legislation passed by the 84th Legislature, the transformed Texas Health and Human Services system consists of three agencies in the 2018-19 biennium, the Texas Health and Human Services Commission, Texas Department of State Health Services, and Texas Department of Family and Protective Services.
Source: Agency FY2018-2019 Legislative Appropriations Requests (LARs).
6 2017 Texas HHS Fact Book
A. Selected Demographic / Socioeconomic Indicators .........................7
B. Texas Population, 2010-2020, By Year .................................................................7
C. Texas Population, 2010-2020, By Year, By Race/Ethnicity ...........................................8
D. Texas Population, 2010-2020, By Year, By Age Group ...................................................9
E. Texas Population, 2010-2050, By Decade........................................................10
F. Texas Population, 2010-2050, By Decade, By Race/Ethnicity .......................10
G. Texas Population, 2010-2050, By Decade, By Age Group ..............................12
H Fifteen Most Populous Texas Counties, By Rank, 2015 ..................................14
I. Fifteen Least Populous Texas Counties, By Rank, 2015 ..................................15
J. Ten Most Populous States, By State, Rank, Total Population, And Race/Ethnicity, July 1, 2015 ..............................16
K. Top Ten States By Change in Total Population Projection, By State,
Rank, And Population 65 And Older, 2010 To 2040 .........................................17
L. Texans By Poverty Income Status, By Race / Ethnicity, Age and Citizenship Status,
2015 .....................................................................18
M. Health Insurance ..............................................19
II — Population
2017 Texas HHS Fact Book 7
A. Selected Demographic / Socioeconomic Indicators
Indicators Texas US
Total Population(in millions, projected for 2017) 1 28.8 326.6
Percent Change in Population (April 1, 2010 to July 1, 2020) 1 21.5% 8.1%
Average Annual Population Growth 1 2.0% 0.8%
Median Household Income 2 $55,653 $55,775
Percent of Population Below Poverty 2 15.9% 14.7%
Percent of Under 18 Population Below Poverty 2
23.0% 20.7%
Percent of Population Uninsured 2 17.1% 9.4%
Percent of Under 18 Population Uninsured 2 9.5% 4.8%
Sources: 1 US Census Bureau. Population Division, National Population Projections, released 2014. Texas Demographic Center at UT San
Antonio. Population Migration Growth Scenario 2000-2010, released 2014.
2 US Census Bureau. American Community Survey, 2015.
B. Texas Population, 2010-2020, By Year
Year Texas Population Percent Change
2010 25,145,561 -
2011 25,631,695 1.9%
2012 26,130,047 1.9%
2013 26,640,165 2.0%
2014 27,161,942 2.0%
2015 27,695,284 2.0%
2016 28,240,245 2.0%
2017 28,797,290 2.0%
2018 29,366,479 2.0%
2019 29,948,091 2.0%
2020 30,541,978 2.0%Source: Texas Demographic Center at UT San Antonio. Population Migration
Growth Scenario 2000-2010.
II — Population
8 2017 Texas HHS Fact Book
Source: Texas Demographic Center at UT San Antonio. Population Migration Growth Scenario 2000-2010.
Year
Rac
e / E
thni
city
Whi
teB
lack
His
pani
cO
ther
Tota
l
2010
11,3
97,3
452,
886,
825
9,46
0,92
11,
400,
470
25,1
45,5
61
2011
11,4
56,0
142,
942,
671
9,76
6,41
11,
466,
599
25,6
31,6
95
2012
11,5
13,5
702,
999,
289
10,0
81,4
881,
535,
700
26,1
30,0
47
2013
11,5
69,9
373,
056,
518
10,4
06,0
701,
607,
640
26,6
40,1
65
2014
11,6
24,8
813,
114,
187
10,7
40,4
561,
682,
418
27,1
61,9
42
2015
11,6
78,1
763,
172,
262
11,0
84,7
631,
760,
083
27,6
95,2
84
2016
11,7
29,6
183,
230,
618
11,4
39,4
021,
840,
607
28,2
40,2
45
2017
11,7
79,1
323,
289,
228
11,8
04,7
951,
924,
135
28,7
97,2
90
2018
11,8
26,4
703,
348,
098
12,1
81,1
672,
010,
744
29,3
66,4
79
2019
11,8
71,5
403,
407,
148
12,5
68,9
142,
100,
489
29,9
48,0
91
2020
11,9
14,0
453,
466,
308
12,9
68,0
262,
193,
599
30,5
41,9
78
II — Population
C. Texas Population, 2010-2020, By Year, By Race/Ethnicity
2017 Texas HHS Fact Book 9
Year
Age
Gro
up
0 -
1718
- 29
30 -
4445
- 54
55 -
6465
+To
tal
2010
6,8
65,8
24
4,4
26,0
08
5,2
18,8
16
3,4
35,3
36
2,5
97,6
91
2,6
01,8
86
25,
145,
561
2011
6,9
44,7
58
4,4
96,1
37
5,3
20,3
69
3,4
61,6
04
2,7
23,5
51
2,6
85,2
76
25,
631,
695
2012
7,0
29,7
68
4,5
68,5
79
5,4
29,3
69
3,4
76,0
80
2,8
08,2
72
2,8
17,9
79
26,
130,
047
2013
7,1
21,4
99
4,6
36,8
54
5,5
41,8
88
3,4
87,2
41
2,8
98,0
69
2,9
54,6
14
26,
640,
165
2014
7,2
16,1
32
4,7
18,2
75
5,6
40,7
82
3,5
09,8
37
2,9
90,5
60
3,0
86,3
56
27,
161,
942
2015
7,3
11,9
23
4,7
98,4
12
5,7
25,1
41
3,5
42,2
91
3,0
91,9
03
3,2
25,6
14
27,
695,
284
2016
7,4
07,6
36
4,8
85,8
49
5,8
05,5
51
3,5
85,5
20
3,1
90,4
52
3,3
65,2
37
28,
240,
245
2017
7,5
00,2
72
4,9
87,4
09
5,8
95,1
84
3,6
24,7
41
3,2
77,4
41
3,5
12,2
43
28,
797,
290
2018
7,5
83,8
16
5,1
07,5
67
5,9
95,1
35
3,6
52,7
04
3,3
56,0
74
3,6
71,1
83
29,
366,
479
2019
7,6
64,5
55
5,2
36,1
51
6,1
07,9
77
3,6
77,7
43
3,4
26,3
05
3,8
35,3
60
29,
948,
091
2020
7,7
53,8
83
5,3
52,2
28
6,2
24,5
04
3,7
16,0
43
3,4
81,2
37
4,0
14,0
83
30,
541,
978
II — Population
D. Texas Population, 2010-2020, By Year, By Age Group
Source: Texas Demographic Center at UT San Antonio. Population Migration Growth Scenario 2000-2010.
10 2017 Texas HHS Fact Book
Year Texas Population Percent Change
2010 25,145,561 -
2020 30,541,978 21.5%
2030 37,155,084 21.7%
2040 44,955,896 21.0%
2050 54,369,297 20.9%
E. Texas Population, 2010-2050, By DecadeYe
arR
ace
/ Eth
nici
ty
Whi
teB
lack
His
pani
cO
ther
Tota
l
2010
11,3
97,3
452,
886,
825
9,46
0,92
11,
400,
470
25,1
45,5
61
2020
11,9
14,0
453,
466,
308
12,9
68,0
262,
193,
599
30,5
41,9
78
2030
12,1
76,4
014,
055,
033
17,5
75,6
563,
347,
994
37,1
55,0
84
2040
12,1
43,6
264,
599,
532
23,1
56,9
685,
055,
770
44,9
55,8
96
2050
11,9
54,6
155,
097,
826
29,8
59,0
127,
457,
844
54,3
69,2
97
Source: Texas Demographic Center at UT San Antonio. Population Migration Growth Scenario 2000-2010.
Source: Texas Demographic Center at UT San Antonio. Population Migration Growth Scenario 2000-2010.
II — Population
F. Texas Population, 2010-2050, By Decade, By Race/Ethnicity
1. Texas Population Projections, By Decade, By Race/Ethnicity, 2010-2050
2017 Texas HHS Fact Book 11
II — Population
2. Texas Population Projections, Proportion of State Population By Race/Ethnicity, 2010-2050
Source: Texas Demographic Center at UT San Antonio. Population Migration Growth Scenario 2000-2010.
F. Texas Population, 2010-2050, By Decade, By Race/Ethnicity
Wh
ite
Bla
ck
His
pa
nic
Oth
er
0%
10
%
20
%
30
%
40
%
50
%
60
%
20
10
20
15
20
20
20
25
20
30
20
35
20
40
20
45
20
50
12 2017 Texas HHS Fact Book
1. Texas Population Projections, By Decade, By Age Group, 2010-2050
Source: Texas Demographic Center at UT San Antonio. Population Migration Growth Scenario 2000-2010.
Year
Age
Gro
up
0 -
1718
- 29
30 -
4445
- 54
55 -
6465
+To
tal
2010
6,8
65,8
24
4,4
26,0
08
5,2
18,8
16
3,4
35,3
36
2,5
97,6
91
2,6
01,8
86
25,
145,
561
2020
7,7
53,8
83
5,3
52,2
28
6,2
24,5
04
3,7
16,0
43
3,4
81,2
37
4,0
14,0
83
30,
541,
978
2030
8,9
39,6
15
6,3
48,9
89
7,6
34,7
56
4,4
69,5
10
3,8
32,7
43
5,9
29,4
71
37,
155,
084
2040
10,
538,
300
7,1
47,5
79
9,5
48,5
41
5,4
73,3
74
4,6
64,7
17
7,5
83,3
85
44,
955,
896
2050
12,
327,
957
8,7
04,5
73
11,
073,
067
7,0
55,1
00
5,7
65,7
35
9,4
42,8
65
54,
369,
297
II — Population
G. Texas Population, 2010-2050, By Decade, By Age Group
2017 Texas HHS Fact Book 13
2. Texas Population Projections, Proportion of State Population by Age Group, 2010-2050
II — Population
Source: Texas Demographic Center at UT San Antonio. Population Migration Growth Scenario 2000-2010.
G. Texas Population, 2010-2050, By Decade, By Age Group
0-1
7
18
-29
30
-44
45
-54
55
-64
65
+
0%
5%
10
%
15
%
20
%
25
%
30
%
20
10
20
15
20
20
20
25
20
30
20
35
20
40
20
45
20
50
14 2017 Texas HHS Fact Book
H. Fifteen Most Populous Texas Counties, By Rank, 2015
Source: Texas Demographic Center at UT San Antonio. Texas Population Estimates Program 2015.
II — Population
Rank County Population Estimate
Percent of State
Population1 Harris 4,530,268 16%
2 Dallas 2,541,528 9%
3 Tarrant 1,960,741 7%
4 Bexar 1,890,984 7%
5 Travis 1,169,907 4%
6 Collin 923,201 3%
7 Hidalgo 841,667 3%
8 El Paso 837,353 3%
9 Denton 778,846 3%
10 Fort Bend 716,491 3%
11 Montgomery 539,335 2%
12 Williamson 495,652 2%
13 Cameron 424,133 2%
14 Nueces 360,168 1%
15 Brazoria 345,717 1%
2017 Texas HHS Fact Book 15
II — Population
I. Fifteen Least Populous Texas Counties, By Rank, 2015
Rank County Population Estimate
1 Loving 81
2 King 294
3 Kenedy 415
4 Borden 674
5 Kent 803
6 McMullen 861
7 Terrell 889
8 Roberts 926
9 Motley 1,104
10 Foard 1,213
11 Sterling 1,304
12 Glasscock 1,333
13 Stonewall 1,411
14 Cottle 1,423
15 Briscoe 1,476
Source: Texas Demographic Center at UT San Antonio. Texas Population Estimates Program 2015.
16 2017 Texas HHS Fact Book
II — Population
J. Ten Most Populous States, By State, Rank, Total Population, And
Race/Ethnicity, July 1, 2015
Stat
eTo
tal
Popu
lati
onR
ank
Tota
l Po
pula
tion
Rac
e / E
thni
city
Whi
teB
lack
His
pani
cO
ther
US
Tota
l32
1,41
8,82
061
.6%
12.4
%17
.6%
8.4%
Cal
iforn
ia1
39,1
44,8
1838
.0%
5.7%
38.8
%17
.5%
Texa
s2
27,4
69,1
1443
.0%
11.8
%38
.8%
6.4%
Flor
ida
320
,271
,272
55.3
%15
.6%
24.5
%4.
7%
New
York
419
,795
,791
56.0
%14
.6%
18.8
%10
.6%
Illin
ois
512
,859
,995
61.9
%14
.1%
16.9
%7.
1%
Penn
sylv
ania
612
,802
,503
77.4
%10
.7%
6.8%
5.1%
Ohi
o7
11,6
13,4
2379
.8%
12.4
%3.
6%4.
3%
Geo
rgia
810
,214
,860
53.9
%30
.9%
9.4%
5.9%
Nor
th C
arol
ina
910
,042
,802
63.8
%21
.4%
9.1%
5.7%
Mic
higa
n10
9,92
2,57
675
.6%
13.9
%4.
9%5.
6%
Source: US Census Bureau. Population Division, Population Estimates. July 1, 2015.
2017 Texas HHS Fact Book 17
Source: IHS Global Insight: U.S Regional Service. December 2016 States’ Core Data Long Term Forecast.
K. Top Ten States By Change in Total Population Projection, By State, Rank, And Population 65 And Older,
2010-2040
Stat
e20
10-2
040
Cha
nge
in t
otal
pop
ulat
ion
2010
-204
0 C
hang
e in
age
65
and
olde
r
Num
ber
Perc
ent
Ran
k N
umbe
rPe
rcen
tR
ank
US
Tota
l 7
1,06
6,31
9 22
.8%
- 3
4,27
0,93
5 80
.6%
-
Uta
h 1
,796
,186
64
.6%
1 4
58,8
24
181.
9%1
Ari
zona
3,6
85,3
84
57.4
%2
989
,203
11
0.7%
7
Texa
s 1
3,83
6,27
1 54
.7%
3 3
,641
,506
13
8.3%
4
Flor
ida
8,7
66,3
84
46.4
%4
2,8
82,9
38
87.6
%21
Col
orad
o 2
,342
,277
46
.3%
5 7
87,7
17
141.
3%3
Nev
ada
1,2
35,7
62
45.7
%6
384
,697
11
7.0%
6
Idah
o 6
70,1
71
42.6
%7
232
,839
11
8.2%
5
Geo
rgia
3,8
42,4
78
39.5
%8
1,0
61,8
35
101.
6%10
Nor
th C
arol
ina
3,3
15,8
46
34.6
%9
1,1
79,4
39
94.6
%14
Sout
h C
arol
ina
1,4
65,2
47
31.6
%10
701
,540
10
9.7%
8
II — Population
18 2017 Texas HHS Fact Book
L. Texans By Poverty Income Status, By Race/Ethnicity, Age and Citizenship Status, 2015
Dem
ogra
phic
C
ateg
ory
PO
VE
RTY
Tota
lR
ate
Inco
me
Bel
owA
bove
Rac
e /
Eth
nici
ty
Whi
te8.
6%99
3,33
410
,543
,552
11,5
36,8
86
Blac
k21
.2%
654,
644
2,42
8,71
63,
083,
360
Hisp
anic
22.6
%2,
371,
751
8,10
8,46
010
,480
,211
Oth
er12
.1%
210,
072
1,53
3,25
51,
743,
327
Age
G
roup
Und
er A
ge 1
822
.7%
1,61
3,80
85,
499,
921
7,11
3,72
9
Ages
18
- 64
13.8
%2,
298,
381
14,2
97,9
5916
,596
,340
Age
65+
10.1
%31
7,61
22,
816,
103
3,13
3,71
5
US
Cit
izen
ship
Stat
us
Nat
ive U
S Ci
tizen
14.9
%3,
317,
704
18,9
59,1
9122
,276
,895
Nat
ural
ized
US
Citiz
en11
.0%
181,
932
1,46
8,74
41,
650,
676
Not
a U
S Ci
tizen
25.0
%73
0,16
52,
186,
048
2,91
6,21
3
Texa
s Tot
al15
.8%
4,22
9,80
122
,613
,983
26,8
43,7
84
Note: Totals may not add up due to rounding. Based on the population for whom the percent of poverty income status was determined.
Source: US Census Bureau, 2015 American Community Survey (ACS) 1-Year Public Use Microdata Sample.
II — Population
2017 Texas HHS Fact Book 19
M. Health Insurance1. Health Insurance Coverage Trends In The US And
Texas: 2011-2015
Year
ALL
AG
ES
Popu
lati
on
Wit
hout
Hea
lth
Insu
ranc
eU
ND
ER
18
Popu
lati
on
Wit
hout
Hea
lth
Insu
ranc
e
Num
ber
Perc
ent
Num
ber
Perc
ent
US
2011
46,3
75,5
3915
.1%
5,52
7,65
77.
5%
2012
45,6
14,5
4714
.8%
5,26
3,80
77.
2%
2013
45,1
80,6
7514
.5%
5,23
4,33
27.
1%
2014
36,6
70,2
2311
.7%
4,39
6,53
66.
0%
2015
29,7
57,5
449.
4%3,
533,
985
4.8%
Texa
s
2011
5,79
6,56
723
.0%
923,
923
13.3
%
2012
5,73
1,90
022
.4%
856,
272
12.3
%
2013
5,71
1,13
922
.0%
879,
498
12.5
%
2014
5,04
2,39
919
.0%
792,
048
11.2
%
2015
4,58
5,92
717
.0%
673,
153
9.4%
II — Population
Note: Totals may not add up due to rounding. Based on the civilian non-institutionalized population.
Source: US - US Census Bureau, 2011-2015 American Community Survey 1-Year Estimates; Texas - US Census Bureau, 2011-2015 American Community Survey (ACS) 1-Year Public Use Microdata Sample.
20 2017 Texas HHS Fact Book
II — Population
2. Texans’ Health Insurance Coverage, By Race/Ethnicity, Age Group And Citizenship Status, 2015
Dem
ogra
phic
Cat
egor
yW
ith
Insu
ranc
eW
itho
ut In
sura
nce
Tota
lN
umbe
rPe
rcen
t
Rac
e/E
thni
city
Whi
te
10,5
21,8
011,
076,
250
9.3%
11,5
98,0
51
Blac
k2,
659,
484
455,
074
14.6
%3,
114,
558
Hisp
anic
7,68
0,06
12,
847,
559
27.0
%10
,527
,620
Oth
er1,
546,
501
207,
044
11.8
%1,
753,
545
Age
G
roup
Und
er A
ge 1
86,
518,
336
673,
153
9.4%
7,19
1,48
9
Ages
18
- 64
12,8
15,4
393,
853,
131
23.1
%16
,668
,570
Age
65+
3,07
4,07
259
,643
1.9%
3,13
3,71
5
US
Cit
izen
ship
Stat
us
Nat
ive U
S Ci
tizen
19,5
56,8
052,
858,
801
12.8
%22
,415
,606
Nat
ural
ized
US
Citiz
en1,
385,
390
265,
174
16.1
%1,
650,
564
Not
a U
S Ci
tizen
1,46
5,65
21,
461,
952
49.9
%2,
927,
604
Texa
s Tot
al22
,407
,847
4,58
5,92
717
.0%
26,9
93,7
74
Note: Totals may not add up due to rounding. Based on the civilian non-institutionalized population.
Source: US Census Bureau, 2015 American Community Survey (ACS) 1-Year Public Use Microdata Sample.
M. Health Insurance
2017 Texas HHS Fact Book 21
II — Population
3. Texans’ Health Insurance Coverage In 2015, By Percent Of Poverty Income Category
M. Health Insurance
Note: Totals may not add up due to rounding. Based on the civilian non-institutionalized population for whom the
percent of poverty income status was determined.
Source: US Census Bureau, 2015 American Community Survey (ACS) 1-Year Public Use Microdata Sample.
Dem
ogra
phic
C
ateg
ory
Wit
h In
sura
nce
Wit
hout
Insu
ranc
eTo
tal
Num
ber
Perc
ent
Perc
ent
of
Pove
rty
Inco
me
Cat
egor
y
100%
2,97
0,36
11,
257,
773
29.7
%4,
228,
134
133%
4,35
7,21
31,
789,
467
29.1
%6,
146,
680
185%
6,41
3,26
52,
508,
206
28.1
%8,
921,
471
200%
6,98
5,10
32,
693,
480
27.8
%9,
678,
583
200%
or
Hig
her
15,2
32,0
621,
866,
809
10.9
%17
,098
,871
Texa
s Tot
al22
,217
,165
4,56
0,28
917
.0%
26,7
77,4
54
22 2017 Texas HHS Fact Book
4. Texans’ Health Insurance Coverage In 2015, By Educational Attainment And For Children By Family Type
II — PopulationD
emog
raph
ic
Cat
egor
yW
ith
Insu
ranc
e
Wit
hout
Insu
ranc
eTo
tal
Num
ber
Perc
ent
Edu
cati
onal
Att
ainm
ent
(For
per
sons
18
and
old
er)
Less
than
Hig
h Sc
hool
2,08
8,85
51,
295,
654
38.3
%3,
384,
509
Hig
h Sc
hool
3,87
0,30
91,
309,
270
25.3
%5,
179,
579
Som
e Co
llege
or A
ssoc
iate
Deg
ree
5,12
7,72
499
8,84
616
.3%
6,12
6,57
0
Colle
ge o
r Hig
her
4,80
2,62
330
9,00
46.
0%5,
111,
627
Tota
l15
,889
,511
3,91
2,77
419
.8%
19,8
02,2
85
Chi
ldre
n B
y Fa
mily
Typ
e
(Dep
ende
nt c
hild
ren
unde
r 18;
app
lies
only
to c
hild
ren
for w
hom
po
verty
inco
me
stat
us
was
det
erm
ined
)
In H
usba
nd-W
ife F
amily
4,30
8,61
144
5,00
09.
4%4,
753,
611
In S
ingl
e Pa
rent
Fam
ily2,
131,
404
218,
329
9.3%
2,34
9,73
3
Tota
l6,
440,
015
663,
329
9.3%
7,10
3,34
4
Note: Totals may not add up due to rounding. Based on the civilian non-institutionalized population.
Source: US Census Bureau, 2015 American Community Survey (ACS) 1-Year Public Use Microdata Sample.
M. Health Insurance
2017 Texas HHS Fact Book 23
— Notes —
24 2017 Texas HHS Fact Book
III — ProgramsREGIONAL CHARACTERISTICSA. Map Of The Eleven Texas HHS Regions ..................................................26
B. Selected Texas Population Projections And Medicaid / CHIP Data ......................................27
FEDERAL POVERTY LEVEL AND INCOME LIMITS
C. 2016 Federal Poverty Levels (FPL) & FPL Limits For Selected Texas HHS
Programs .............................................................29
MEDICAID AND CHIPD. Estimated Number Of Children Eligible For
Medicaid Or CHIP, Number Of Children Enrolled, And The Estimated Number Of Eligible Children Who Remain Unenrolled,
SFYs 2015-2019 .................................................31
E. Medicaid and CHIP Caseloads .........................32
2017 Texas HHS Fact Book 25
III — ProgramsTANFF. Temporary Assistance For Needy Families (TANF) .................................................34
SNAPG. Average Monthly SNAP Cases, Recipients
And Payments, By State Fiscal Year (SFY), SFYs 2009-2015 .................................................36
H. Percentage Breakdown of SNAP Recipients, By Age, By State Fiscal Year (SFY), SFYs 2009-2015 .................................................37
I. Changes in Client Services Populations: Impact of Managed Care Expansion Items,
State Fiscal Years (SFY), 2014-2019 ..............38
ExPENDITURESJ. Medicaid Expenditures.......................................40
K. CHIP Expenditures, Federal, Non-Federal And Total, By Year, Federal Fiscal Years (FFY)
2000-2017 ...........................................................43
L. Recipients And Expenditures ......................44
M. History Of Texas Medicaid Percentage Match ...................................................................49
26 2017 Texas HHS Fact Book
1
2 3 4
5
6
7
8
910
11
A. Map Of The Eleven Texas HHS Regions
III — Programs
HHS Regions
1 — High Plains
2 — Northwest Texas
3 — Metroplex
4 — Upper East Texas
5 — Southeast Texas
6 — Gulf Coast
7 — Central Texas
8 — Upper South Texas
9 — West Texas
10 — Upper Rio Grande
11 — Lower South Texas
2017 Texas HHS Fact Book 27
1. 2015 Texas Population Estimates And Under 19 Population Estimates, By HHS Region
III — Programs
B. Selected Texas Population Projections And Medicaid / CHIP Data
HHS Region
Percent Of Texas
Population
Percent Of Texas
Under 19 Population
1 - High Plains 3.2% 3.2%
2 - Northwest Texas 2.0% 1.8%
3 - Metroplex 26.9% 27.1%
4 - Upper East Texas 4.2% 3.7%
5 - Southeast Texas 2.8% 2.6%
6 - Gulf Coast 24.8% 24.8%
7 - Central Texas 12.0% 11.5%
8 - Upper South Texas 10.4% 10.2%
9 - West Texas 2.3% 2.3%
10 - Upper Rio Grande 3.1% 3.4%
11 - Lower South Texas 8.2% 9.4%
Texas Population Totals 27,469,114 8,048,884
Note: Totals may not add up due to rounding.
Source: Texas Demographic Center at UT San Antonio. Texas Population Estimates Program 2015.
28 2017 Texas HHS Fact Book
2. 2015 Texas Medicaid / CHIP Enrollment And Percent Of Texas Population Receiving Medicaid
& CHIP, By HHS Region
III — Programs
Notes: 1 Excludes CHIP Perinatal Program.
Total Texas Medicaid and CHIP Enrollment reported here may be lower than reported elsewhere because individuals with program type codes for specified low-income Medicare benefits (SLMB), qualified Medicare beneficiary (QMB), undocumented alien with emergency care only, and Healthy Texas Women were omitted since these programs do not provide full Medicaid benefits.
Totals may not add up due to rounding. Source: Texas Medicaid Program. 8-month Enrollment History File: CY 2015.
US Census Bureau, 2013-2015 American Community Survey (ACS) for Texas. CHIP Monthly Enrollment CY 2015.
HHS Region
Percent Of Total Medicaid & CHIP
Enrollment
Percent Of HHS Region Population Receiving
Medicaid & CHIP
1 - High Plains 3.1% 15.9%
2 - Northwest Texas 2.0% 15.6%
3 - Metroplex 23.8% 15.2%
4 - Upper East Texas 4.4% 17.1%
5 - Southeast Texas 3.1% 17.5%
6 - Gulf Coast 23.6% 16.7%
7 - Central Texas 9.2% 13.4%
8 - Upper South Texas 10.9% 18.1%
9 - West Texas 2.0% 15.0%
10 - Upper Rio Grande 4.3% 22.3%
11 - Lower South Texas 13.7% 28.1%
Total Texas Medicaid & CHIP1 Enrollment
4,394,501
B. Selected Texas Population Projections And Medicaid / CHIP Data
2017 Texas HHS Fact Book 29
III — Programs
1. Percent Of Federal Poverty Levels, 2016
C. 2016 Federal Poverty Levels (FPL) & FPL Limits For Selected Texas HHS Programs
Fam
ily
Size
11%
16%
74%
100%
133%
144%
185%
198%
201%
220%
1$1
,295
$1
,883
$
8,71
0 $
11,8
80
$15,
800
$17,
107
$21,
978
$23,
522
$23,
879
$26,
136
2$1
,752
$2
,549
$
11,7
88
$16
,020
$2
1,30
7 $2
3,06
9 $2
9,63
7 $3
1,72
0 $3
2,20
0 $3
5,24
4
3$2
,210
$3
,214
$
14,8
67
$20
,160
$2
6,81
3 $2
9,03
0 $3
7,29
6 $3
9,91
7 $4
0,52
2 $4
4,35
2
4 $
2,66
8 $
3,88
0 $
17,9
45
$24
,300
$
32,3
19
$34
,992
$
44,9
55
$48
,114
$
48,8
43
$53
,460
5$3
,125
$4
,546
$
21,0
23
$28
,440
$3
7,82
5 $4
0,95
4 $5
2,61
4 $5
6,31
1 $5
7,16
4 $6
2,56
8
6$3
,583
$5
,211
$
24,1
02
$32
,580
$4
3,33
1 $4
6,91
5 $6
0,27
3 $6
4,50
8 $6
5,48
6 $7
1,67
6
7$4
,040
$5
,877
$
27,1
80
$36
,730
$4
8,85
1 $5
2,89
1 $6
7,95
1 $7
2,72
5 $7
3,82
7 $8
0,80
6
8$4
,498
$6
,542
$
30,2
59
$40
,890
$5
4,38
4 $5
8,88
2 $7
5,64
7 $8
0,96
2 $8
2,18
9 $8
9,95
8
Source: Federal Register; Vol. 81, No. 15. January 25, 2016, pp. 4036-4037.
30 2017 Texas HHS Fact Book
III — Programs
C. 2016 Federal Poverty Levels (FPL) & FPL Limits For Selected Texas HHS Programs
Percent of FPL Program Eligibility Groups
11% Parent with two TANF children (monthly income limit is $188)
16% Medicaid Medically Needy Program(for family of 3, monthly income limit is $275)
17% TANF child (for family of 3, maximum grant is $286 per month)
74% Medicaid SSI (excluding Long-Term Care disabled)
130%Supplemental Nutrition Assistance Program(SNAP)
133%1 Medicaid children ages 6-18
144%1 Medicaid children ages 1-5 (excluding Long-Term Care disabled)
185% WIC program
198%1 Medicaid infants under age 1, pregnant women
201%1 CHIP
220% Medicaid Long-Term Care
2. Poverty Income Limits Associated With Selected HHS Programs
Notes: 1 Affordable Care Act modified adjusted gross income (MAGI) group standard.
Source: Center for Analytics and Decision Support, Texas Health and Human Services Commission.
2017 Texas HHS Fact Book 31
III — Programs
D. Estimated Number Of Children Eligible For Medicaid Or CHIP, Number Of Children Enrolled, And The Estimated Number Of Eligible Children Who Remain Unenrolled, SFYs 2015-2019
SFY
Estimated Unduplicated
Yearly Enrollment
Average Monthly
Enrollment1
Estimated Number
of Eligible Children
Who Remain
Unenrolled
Enroll-ment Rate
Children's Medicaid2015 3,653,000 2,962,139 590,000 83%
2016 3,730,000 2,971,621 665,000 82%
2017 3,784,000 3,013,815 696,000 81%
2018 3,838,000 3,057,508 723,000 81%
2019 3,919,000 3,121,417 728,000 81%
CHIP2015 626,000 339,831 106,000 76%
2016 619,000 360,788 94,000 79%
2017 647,000 387,314 83,000 82%
2018 682,000 407,952 102,000 80%
2019 715,000 427,793 107,000 80%
Children's Medicaid & CHIP2015 4,279,000 3,301,971 696,000 83%
2016 4,349,000 3,332,409 759,000 81%
2017 4,431,000 3,401,129 779,000 81%
2018 4,520,000 3,465,460 825,000 81%
2019 4,634,000 3,549,211 835,000 81%
Notes: Estimates account for citizenship and income status of population (insurance status is also considered for CHIP). However, these estimates do not account for other factors considered during eligibility determination, such as resources.
1 Average Monthly Enrollment from November 2016 Forecast Update. Sources: US Census Bureau, 2013-2015 American Community Survey (ACS) for
Texas.
32 2017 Texas HHS Fact Book
Note: 1 SFY 2016-2019 caseload values are forecast and subject to change.
Source: November 2016 Forecast Update, System Forecasting, Texas Health and Human Services Commission.
1. Medicaid Aged, Disabled, Poverty-Level Adults, Pregnant Women, Non-Disabled Children, And Total Medicaid, SFYs 2011-2019
E. Medicaid And CHIP Caseloads1
III — Programs
SFY
Age
d an
d M
edic
are
Rel
ated
Dis
abili
ty
Rel
ated
Pove
rty-
Leve
l Pa
rent
s/A
dult
s
Pre
gnan
t W
omen
Chi
ldre
n 0-
18, N
on-
Dis
abili
ty
Rel
ated
Tota
l M
edic
aid
2011
356
,656
3
90,8
19
104
,573
1
27,3
13
2,5
63,6
96
3,5
43,0
57
2012
363
,770
4
08,9
16
121
,358
1
26,3
14
2,6
35,5
71
3,6
55,9
30
2013
366
,748
4
20,3
27
127
,063
1
29,0
84
2,6
15,4
07
3,6
58,6
29
2014
372
,550
4
26,0
08
134
,662
1
36,8
11
2,6
76,6
58
3,7
46,6
89
2015
374
,105
4
26,9
73
152
,119
1
41,3
66
2,9
62,1
39
4,0
56,7
02
2016
1 3
74,0
58
427
,424
1
47,2
48
140
,403
2
,971
,621
4
,060
,753
2017
1 3
77,0
51
422
,966
1
49,8
42
142
,957
3
,013
,815
4
,106
,631
2018
1 3
81,5
72
428
,070
1
54,3
66
142
,053
3
,057
,508
4
,163
,570
2019
1 3
87,2
90
434
,306
1
58,1
29
143
,645
3
,121
,417
4
,244
,788
2017 Texas HHS Fact Book 33
SFYMedicaid Children’s
Risk Groups
CHIP Caseload
CHIP CHIP Perinatal
TOTAL CHIP
2013 2,615,407 593,619 37,027 630,646
2014 2,676,658 524,658 36,825 561,483
2015 2,962,139 339,831 36,535 376,366
20161 2,971,621 360,788 35,069 395,857
20171 3,013,815 387,314 35,448 422,762
20181 3,057,508 407,952 35,461 443,412
20191 3,121,417 427,793 35,450 463,244
Note: CHIP Perinatal contains newborns < 185% FPL moving to Medicaid beginning SFY 2011. Traditional CHIP contains the Affordable Care Act (ACA) impact beginning Jan-14: moving caseload under 138% FPL to Medicaid. Medicaid Children contains ACA impacts beginning Jan-14: Eligible clients not enrolled, 12-month recertification impact, and CHIP under 133 FPL.
1 SFY 2016-2019 caseload values are forecast and subject to change.
Source: November 2016 Forecast Update, System Forecasting, Texas Health and Human Services Commission.
2. Medicaid Children’s Risk Groups, CHIP, CHIP Perinatal, And Total CHIP, SFYs 2013-2019
III — Programs
E. Medicaid And CHIP Caseloads1
34 2017 Texas HHS Fact Book
III — Programs
SFY
Cas
esR
ecip
ient
sC
hild
ren
Adu
lts
Paym
ents
Ave
rage
Pa
ymen
t
Per
Cas
e Pe
r R
ecip
ient
2013
37,5
57 8
9,72
4 7
7,52
2 1
2,20
2 $
6,39
0,76
2 $
170
$71
2014
32,5
85 7
7,40
3 6
7,49
5 9
,908
$5
,608
,917
$
172
$72
2015
28,1
70 6
7,26
9 5
9,19
7 8
,072
$
4,90
6,73
7 $
174
$73
2016
25,0
37 6
0,37
5 5
2,52
6 7
,849
$
4,46
0,31
3 $
178
$74
1. TANF BASIC Program — State Fiscal Year (SFY) Average Monthly: Cases, Recipients, Payments And Average Payments, SFYs 2013-2016
Notes: TANF Basic Program consists of cases which received a benefit in the reporting month. TANF Basic is the assistance program for qualifying child-only or single parent families funded with Federal dollars. A single case may contain multiple recipients.
Source: TANF Payment Files, Center for Analytics and Decision Support, Texas Health and Human Services Commission. 2013-16 update based on the October 2016 TANF Forecast for cases, recipients and payments. 2015-16 Children and Adult counts from TANF Annual Reports percentages.
F. Temporary Assistance For Needy Families (TANF)
2017 Texas HHS Fact Book 35
2. TANF STATE Program — State Fiscal Year (SFY) Average Monthly: Cases, Recipients, Payments And Average Payments, SFYs 2013-2016
Notes: TANF State Program consists of cases which received a benefit in the reporting month. TANF State is the assistance program for qualifying 2-parent families funded with State dollars. A single case may contain multiple recipients.
Source: TANF Payment Files, Center for Analytics and Decision Support, Texas Health and Human Services Commission. 2013-16 update based on the October 2016 TANF Forecast for cases, recipients and payments. 2015-16 Children and Adult counts from TANF Annual Reports percentages.
III — Programs
SFY
Cas
esR
ecip
ient
sC
hild
ren
Adu
lts
Paym
ents
Ave
rage
Pa
ymen
t
Per
Cas
e Pe
r R
ecip
ient
2013
1,0
52
4,4
78
2,3
73
2,1
05
$31
0,32
9 $
295
$69
2014
916
3
,870
2
,038
1
,833
$
267,
127
$29
1 $
69
2015
1,1
71
4,2
64
2,5
58
1,7
06
$30
7,53
4 $
263
$72
2016
951
3
,399
2
,039
1
,360
$
252,
209
$26
5 $
74
F. Temporary Assistance For Needy Families (TANF)
36 2017 Texas HHS Fact Book
III — Programs
Source: Monthly Texas Supplemental Nutrition Assistance Program (SNAP) Client Level Cutoff File, System Forecasting, Texas Health and Human Services Commission.
G. Average Monthly SNAP Cases, Recipients, Total Payments And Average Payment Per Case, By State Fiscal Year (SFY), SFYs 2009-2015
SFY
Num
ber
of C
ases
Num
ber
of
Rec
ipie
nts
Tota
l Pa
ymen
ts
Ave
rage
Pa
ymen
t Pe
r C
ase
2009
1,2
12,2
34
3,0
89,1
05
$35
2,97
2,47
2 $
291
2010
1,4
08,6
97
3,5
84,4
34
$43
5,37
6,08
4 $
309
2011
1,7
17,7
32
4,2
81,4
92
$48
1,84
7,14
5 $
281
2012
1,7
54,1
08
4,2
11,2
29
$50
2,18
3,01
3 $
286
2013
1,7
10,4
92
4,1
22,2
27
$49
4,81
9,04
2 $
289
2014
1,6
41,1
45
3,9
32,9
62
$44
6,69
0,07
3 $
272
2015
1,5
83,5
26
3,7
86,3
44
$436
,111
,442
$
275
2017 Texas HHS Fact Book 37
Notes: These data are from a one-month snapshot, yet these proportions remain fairly stable over time. Totals may not add up due to rounding.
Source: Monthly Texas Supplemental Nutrition Assistance Program (SNAP) Client Level Cutoff File, System Forecasting, Texas Health and Human Services Commission.
III — ProgramsSF
YR
ecip
ient
s
Age
s <
5A
ges
5
- 17
Age
s 18
- 59
Age
s 60
- 64
Age
s 65
+
2009
20.0
%36
.4%
35.7
%1.
9%6.
0%
2010
19.4
%36
.2%
36.8
%2.
1%5.
6%
2011
19.1
%36
.3%
36.8
%2.
2%5.
6%
2012
18.5
%36
.4%
36.8
%2.
3%5.
9%
2013
17.9
%37
.0%
36.4
%2.
4%6.
3%
2014
17.4
%37
.5%
35.8
%2.
6%6.
7%
2015
17.1
%38
.1%
35.9
%2.
6%6.
3%
H. Percentage Breakdown of SNAP Recipients, By Age, By State Fiscal Year (SFY), SFYs 2009-2015
38 2017 Texas HHS Fact Book
Note: 1 Expansion items include only those Managed Care (MC) expansions implemented on/before November 2016. Additional MC expansions are pending.
2 SFYs 2016-2019 are forecast and subject to change.
Source: November 2016 Forecast Update, System Forecasting, Texas Health and Human Services Commission.
Program Type SFY 2014
SFY 2015
SFY 20162
FEE-FOR-SERVICE 734,427 532,121 490,327
% of total caseload 19.6% 13.1% 12.1%
MANAGED CARE 3,012,262 3,524,581 3,570,427
% of total caseload 80.4% 86.9% 87.9%
• HMO (STAR) 2,139,382 2,498,789 2,501,017
% of total caseload 57.1% 61.6% 61.6%
• STAR+Plus 410,999 538,385 536,673
% of total caseload 11.0% 13.3% 13.2%
• MRSA (STAR HMO) 431,149 442,544 455,290
% of total caseload 11.5% 10.9% 11.2%
• STAR Health 30,732 30,909 30,904
% of total caseload 0.8% 0.8% 0.8%
• Dual Demo - 13,954 46,542
% of total caseload - 0.3% 1.1%
• STAR Kids - - -
% of total caseload - - -
• Breast and Cervical Cancer Program - - -
% of total caseload - - -
TOTAL (FFS + MC) 3,746,689 4,056,702 4,060,753
III — Programs
I. Changes in Client Services Populations: Impact of Managed Care Expansion Items1, State Fiscal Years (SFY) 2014-20192
2017 Texas HHS Fact Book 39
III — Programs
I. Changes in Client Services Populations: Impact of Managed Care Expansion Items1, State Fiscal Years (SFY) 2014-2019 (continued)2
Program Type SFY 20172
SFY 20182
SFY 20192
FEE-FOR-SERVICE 373,518 294,749 300,355
% of total caseload 9.1% 7.1% 7.1%
MANAGED CARE 3,733,113 3,868,821 3,944,433
% of total caseload 90.9% 92.9% 92.9%
• HMO (STAR) 2,526,216 2,607,923 2,662,389
% of total caseload 61.5% 62.6% 62.7%
• STAR+Plus 527,768 531,454 538,978
% of total caseload 12.9% 12.8% 12.7%
• MRSA (STAR HMO) 467,629 482,633 492,625
% of total caseload 11.4% 11.6% 11.6%
• STAR Health 32,011 32,479 32,808
% of total caseload 0.8% 0.8% 0.8%
• Dual Demo 42,116 42,201 42,802
% of total caseload 1.0% 1.0% 1.0%
• STAR Kids 137,372 167,442 170,111
% of total caseload 3.3% 4.0% 4.0%
• Breast and Cervical Cancer Program - 4,689 4,719
% of total caseload - 0.1% 0.1%
TOTAL (FFS + MC) 4,106,631 4,163,570 4,244,788
Note: 1 Expansion items include only those Managed Care (MC) expansions implemented on/before November 2016. Additional MC expansions are pending.
2 SFYs 2016-2019 are forecast and subject to change.
Source: November 2016 Forecast Update, System Forecasting, Texas Health and Human Services Commission.
40 2017 Texas HHS Fact Book
Note: Totals may not add up due to rounding.
Sources: CMS37 and CMS21B Quarterly Reports. 8/15/16, Financial Services, Texas Health and Human Services Commission.
1. Federal Fiscal Years (FFY) 1970-2017, Federal, Non-Federal And Total Expenditures, By Year
FFY Federal Non-Federal TOTAL
1970 $89.3 $47.6 $136.9
1975 $302.3 $173.0 $475.3
1980 $627.6 $435.8 $1,063.4
1985 $875.5 $713.6 $1,589.0
1990 $1,993.3 $1,262.8 $3,256.1
1995 $5,734.2 $3,363.2 $9,097.4
2000 $6,911.0 $4,380.1 $11,291.1
2001 $7,434.1 $4,863.6 $12,297.7
2002 $8,573.2 $5,696.4 $14,269.6
2003 $9,954.6 $6,246.8 $16,201.3
2004 $10,443.7 $6,360.6 $16,804.3
2005 $10,927.9 $7,024.7 $17,952.6
2006 $11,192.6 $7,410.8 $18,603.5
2007 $12,812.9 $8,563.6 $21,376.4
2008 $13,308.5 $9,000.7 $22,309.2
2009 $16,370.6 $8,186.3 $24,556.9
III — Programs
J. Medicaid Expenditures (in millions)
2017 Texas HHS Fact Book 41
FFY Federal Non-Federal TOTAL
2010 $19,086.7 $8,563.8 $27,650.5
2011 $19,308.6 $10,124.8 $29,433.4
2012 $16,986.9 $12,361.3 $29,348.2
2013 $17,479.3 $12,054.2 $29,533.5
2014 $19,810.5 $13,584.0 $33,394.5
2015 $21,723.0 $15,246.7 $36,969.7
20161 $24,525.8 $18,047.2 $42,573.0
20171 $24,258.5 $18,353.5 $42,612.0
III — Programs
J. Medicaid Expenditures (in millions) 1. Federal Fiscal Years (FFY) 1970-2017, Federal, Non-
Federal And Total Expenditures, By Year (continued)
Notes: 1 Data for these years are estimates. Totals may not add up due to rounding.
Includes Disproportionate Share Hospital (DSH), Upper Payment Limit (UPL), Uncompensated Care (UC), and DSRIP Payments.
This report includes the increased Federal Funds from American Recovery and Reinvestment Act (ARRA) dollars through CMS. ARRA funds for client services ended with 3rd quarter 2011, but prior period expenditures continued to draw ARRA funds for eight quarters.
ARRA admin increase includes Health Information Technology (HIT) admin federal match which is still active.
Affordable Care Act (ACA) will have increased federal match for Balancing Improvement Program (BIP) which began 10/1/12 and ended 9/30/15.
Medicaid program expansions funded by CHIP (Title XXI) represent two populations - (1) From 1998 - 2003, CHIP Phase 1 was a short-term Medicaid Expansion implemented during the initial authorization of CHIP; and (2) Beginning 2011, Medicaid children who were Qualified Aliens were considered as a Medicaid Expansion. In January 2014, CHIP children under 138% FPL also moved to Medicaid as part of the Medicaid Expansion. These Medicaid Expansion children all are matched with Title XXI funds.
As of 8/15/2016, FFY1998-FFY2015 were updated with reported expenditure information from the CMS electronic system. The actual expenditure information includes prior year expenditures as reported each quarter.
Sources: CMS37 and CMS21B Quarterly Reports, 8/15/16, Financial Services, Texas Health and Human Services Commission.
42 2017 Texas HHS Fact Book
Notes: * Data for these years are estimates. 1 Uncompensated Care (UC) funds replace UPL beginning September
2011. 2 The ‘Other’ category includes: Clawback, CHIP Title XXI (for FFYs
2011 - 2017), Administration, and Survey and Certification. As of 8/15/2016, FFY2006-FFY2015 were updated with reported
expenditure information from the CMS electronic system. The actual expenditure information includes prior year expenditures as reported each quarter.
Totals may not add up due to rounding.
Sources: CMS37 and CMS21B Quarterly Reports, 8/15/16, Financial Services, Texas Health and Human Services Commission.
2. Federal Fiscal Years (FFYs) 2006-2017, By Year
J. Medicaid Expenditures (in millions)FF
YG
rant
B
enefi
ts
Dis
prop
orti
onat
e Sh
are
Hos
pita
l P
rogr
am (D
SH)
Upp
er
Paym
ent
Lim
its
(UPL
)
Unc
omp-
ensa
ted
Car
e an
d D
SRIP
1O
ther
2T
OTA
L
2006
$15,
620
$1,5
43$5
27-
$914
$18,
604
2007
$16,
177
$1,4
38$2
,664
-$1
,098
$21,
376
2008
$17,
841
$1,4
59$1
,797
-$1
,212
$22,
309
2009
$19,
241
$1,7
46$2
,013
-$1
,557
$24,
557
2010
$21,
501
$1,6
88$3
,142
-$1
,320
$27,
651
2011
$23,
230
$1,5
79$3
,039
-$1
,586
$29,
433
2012
$23,
613
$1,5
16$2
,395
-$1
,825
$29,
348
2013
$23,
830
$227
-$3
,696
$1,7
81$2
9,53
4
2014
$25,
171
$1,5
26-
$4,6
88$2
,009
$33,
394
2015
$26,
540
$2,3
38-
$5,8
14$2
,278
$36,
970
2016
*$2
8,74
0$2
,536
-$8
,796
$2,4
99$4
2,57
1
2017
*$3
1,85
0$1
,853
-$6
,128
$2,7
82$4
2,61
3
III — Programs
2017 Texas HHS Fact Book 43
K. CHIP Expenditures, Federal, Non-Federal And Total (in millions), By Year, Federal Fiscal Years (FFY) 2000-
2017FFY Federal Non-Federal TOTAL2000 $41.4 $15.4 $56.8
2001 $264.0 $100.6 $364.7
2002 $535.7 $207.1 $742.8
2003 $405.6 $157.9 $563.5
2004 $282.5 $109.0 $391.5
2005 $287.7 $108.5 $396.1
2006 $269.4 $102.4 $371.8
2007 $385.7 $145.9 $531.6
2008 $701.2 $267.5 $968.7
2009 $702.2 $279.2 $981.4
2010 $776.3 $315.4 $1,091.7
2011 $853.8 $325.8 $1,179.6
2012 $849.4 $351.3 $1,200.7
2013 $918.8 $366.2 $1,285.0
2014 $865.6 $352.3 $1,217.9
2015 $956.4 $397.7 $1,354.1
20161 $1,266.8 $95.5 $1,362.3
20171 $1,551.5 $128.9 $1,680.4
Notes: 1 Data for these years are estimates. Medicaid program expansions funded by CHIP (Title XXI) represent two
populations - (1) From 1998 - 2003, CHIP Phase 1 was a short-term Medicaid Expansion implemented during the initial authorization of CHIP; and (2) Beginning 2011, Medicaid children who were Qualified Aliens were considered as a Medicaid Expansion. In January 2014, CHIP children under 138% FPL also moved to Medicaid as part of the Medicaid Expansion. These Medicaid Expansion children all are matched with Title XXI funds. Expenditure information on this report includes Medicaid Expansion children. As of 10/1/15, CHIP had an enhanced match rate of 92.99% federal, which greatly decreased the Non-Federal portion of Federal Fiscal Year for FFY 2016. An additional 23% over standard EFMAP is expected to continue through FFY 2019.
As of 8/15/2016, FFY2000-FFY2015 were updated with reported expenditure information from the CMS electronic system. The actual expenditure information includes prior year expenditures as reported each quarter.
Totals may not add up due to rounding.
Sources: CMS37 and CMS21B Quarterly Reports, 8/15/16, Financial Services, Texas Health and Human Services Commission.
III — Programs
44 2017 Texas HHS Fact Book
1. Texas Medicaid Expenditures By Service Type, State Fiscal Year 2015
Notes: Totals may not add up due to rounding.
Sources: Ad Hoc Query Platform Claims, CMS, Vendor Drug, Encounter Universes, TMHP, Center for Analytics and Decision Support Supplemental Payments Databases, System Forecasting, Texas Health and Human Services Commission.
Service Group Expenditure Percent
Physician and Professional $7,554,618,046 22%
Long-Term Services and Supports $7,193,559,762 21%
Hospital Inpatient $3,789,722,261 11%
Prescription Drugs $3,182,294,461 9%
Hospital and Clinic Out-Patient $3,133,375,181 9%
Dental $1,173,857,422 3%
Supplemental Payments $8,512,294,507 25%
Uncompensated Care and Delivery System Reform Incentive Payment (DSRIP)
$5,919,825,028 70%
Disproportionate Share Hospital (DSH) Program $1,722,499,027 20%
Delivery Supplemental Payments (DSP) $496,358,058 6%
Medicare Part D $373,612,394 4%
All Groups $34,539,721,640 100%
III — Programs
L. Recipients And Expenditures
2017 Texas HHS Fact Book 45
Notes: Costs and caseload for all Medicaid payments for full beneficiaries and non-full beneficiaries (Women’s Health Waiver, Emergency Services for Non-Citizens, Medicare payments) are included.
Source: November 2016 Forecast Update, System Forecasting, Texas Health and Human Services Commission.
2. Texas Medicaid Beneficiaries, By Recipient Group, State Fiscal Year 2015
III — Programs
L. Recipients And Expenditures
3. Texas Medicaid Expenditures, By Recipient Group, State Fiscal Year 2015
24%
7%
69%
0% 10% 20% 30% 40% 50% 60% 70%
Aged & Disability-Related
Non-Disabled Adults
Non-Disabled Children
Caseload
59%
9%
32%
0% 10% 20% 30% 40% 50% 60% 70%
Aged & Disability-Related
Non-Disabled Adults
Non-Disabled Children
Cost
46 2017 Texas HHS Fact Book
Ris
k G
roup
Ave
rage
Mon
thly
Acu
te C
are
Med
ical
and
Dru
g C
osts
2
FY 2
015
FY 2
0161
FY 2
0171
FY 2
0181
FY 2
0191
Dis
abili
ty-R
elat
ed $
1,14
7.48
$
1,19
8.85
$
1,23
0.29
$
1,28
9.97
$
1,35
5.01
Preg
nant
Wom
en $
721.
79
$74
9.86
$
765.
55
$77
6.56
$
794.
13
New
born
s $
669.
12
$67
0.09
$
691.
26
$69
6.83
$
719.
47
TAN
F Pa
rent
s $
453.
08
$44
6.10
$
468.
50
$49
1.42
$
517.
37
Ove
rall
Acu
te C
are
/ Dru
g C
ost
$34
6.08
$
353.
52
$35
8.00
$
369.
20
$38
4.26
Chi
ldre
n A
ges
1-18
, Non
-Dis
able
d $
196.
51
$19
8.47
$
200.
76
$20
5.33
$
214.
33
Age
d &
Med
icar
e R
elat
ed 3
$92
.19
$97
.95
$98
.17
$10
0.69
$
103.
73
Notes: 1 FY 2016-2019 are forecast and subject to change. 2 Costs are through November 2016 and include all Acute Care
services for Full-Benefit Medicaid clients, including Dental and Drug Costs.
3 Aged and Medicare Related Costs do not include costs paid for Part A and Part B Premiums for Full and Partial Dual Eligible Clients. Costs in the Aged and Medicare Related Risk Group include only those co-payments, deductibles, and drugs not covered through Medicare.
Source: Texas Health and Human Services Commission, Financial Services, System Forecasting, November 2016 Caseload/Cost Forecast, Full Client Forecast.
4. Average Monthly Acute Care Medical and Drug Costs, By Risk Group, Ranked by Per Member
Per Month (PMPM), SFYs 2015-20191
L. Recipients And Expenditures
III — Programs
2017 Texas HHS Fact Book 47
— Notes —
48 2017 Texas HHS Fact Book
5. Top Ten States Ranked By Medicaid Expenditures, Total Population, Medicaid Enrollment, And Per Capita Medicaid Spending, 2015
L. Recipients And ExpendituresSt
ate
Tota
l M
edic
aid
Exp
endi
ture
s (in
billi
ons)
1
Popu
lati
on 2
Med
icai
d E
nrol
lmen
t 3
Per
Cap
ita
Med
icai
d
Ran
kN
umbe
rR
ank
Num
ber
Ran
kA
mou
nt
Cal
iforn
ia $
85.5
1
39,1
44,8
181
12,
648,
637
7 $
2,18
5
New
York
$59
.8
419
,795
,791
2 6
,512
,137
1
$3,
021
Texa
s $
35.8
2
27,4
69,1
143
4,6
78,3
94
34 $
1,30
4
Penn
sylv
ania
$23
.4
612
,802
,503
7 2
,665
,455
17
$1,
827
Ohi
o $
21.6
7
11,6
13,4
236
2,9
88,9
34
15 $
1,86
0
Flor
ida
$21
.5
320
,271
,272
4 3
,558
,092
42
$1,
059
Illin
ois
$17
.0
512
,859
,995
5 3
,162
,522
33
$1,
325
Mic
higa
n $
15.9
10
9,92
2,57
68
2,3
52,1
27
20 $
1,60
7
Mas
sach
uset
ts $
15.6
15
6,79
4,42
213
1,6
49,4
23
5 $
2,29
1
New
Jers
ey $
14.2
11
8,95
8,01
310
1,7
89,2
64
22 $
1,58
9
III — Programs
2017 Texas HHS Fact Book 49
5. Top Ten States Ranked By Medicaid Expenditures, Total Population, Medicaid Enrollment, And Per Capita Medicaid Spending, 2015 (continued)
III — Programs
Not
es:
1 Med
icai
d Ex
pend
iture
s —
Dat
a ar
e fo
r FF
Y 2
015.
Med
icai
d ex
pend
iture
s do
not
incl
ude
adm
inis
trat
ive
cost
s, ac
coun
ting
adju
stm
ents
, or
the
U.S
. Ter
rito
ries
. Tot
al M
edic
aid
spen
ding
incl
udin
g th
ese
addi
tiona
l ite
ms
was
$55
2.0
billi
on in
FFY
201
5.
2 T
otal
Pop
ulat
ion
— A
s of
July
1, 2
015.
3 M
edic
aid
Enro
llmen
t —
Dat
a ar
e fo
r Ju
ly 2
015.
The
tot
al u
ndup
licat
ed n
umbe
r of
indi
vidu
als
enro
lled
in M
edic
aid
and
CH
IP a
s of
the
la
st d
ay o
f eac
h re
port
ing
peri
od, i
nclu
ding
tho
se w
ith r
etro
activ
e, c
ondi
tiona
l, an
d pr
esum
ptiv
e el
igib
ility
. Thi
s in
dica
tor
is a
poi
nt-in
-tim
e co
unt
of t
otal
pro
gram
enr
ollm
ent,
and
is n
ot s
olel
y a
coun
t of
tho
se n
ewly
enr
olle
d du
ring
the
rep
ortin
g pe
riod
. Thi
s nu
mbe
r in
clud
es o
nly
thos
e in
divi
dual
s w
ho a
re e
ligib
le fo
r co
mpr
ehen
sive
ben
efits
(e.
g., e
mer
genc
y M
edic
aid,
fam
ily p
lann
ing-
only
cov
erag
e an
d lim
ited
bene
fit d
ual e
ligib
le in
divi
dual
s ar
e ex
clud
ed).
Med
icai
d Se
ctio
n 11
15 d
emon
stra
tion
popu
latio
ns a
re in
clud
ed a
s lo
ng a
s th
e be
nefit
s an
d ne
twor
ks a
re c
ompr
ehen
sive
.
Sour
ces:
Med
icai
d Ex
pend
iture
s —
Dat
a ar
e fr
om T
he K
aise
r Fa
mily
Fou
ndat
ion
Stat
e H
ealth
Fac
ts. D
ata
Sour
ce: U
rban
Inst
itute
est
imat
es
base
d on
dat
a fr
om C
MS
(For
m 6
4) (
as o
f 9/1
/16)
.
To
tal P
opul
atio
n —
Ann
ual E
stim
ates
of t
he R
esid
ent
Popu
latio
n fo
r th
e U
nite
d St
ates
, Reg
ions
, Sta
tes,
and
Puer
to R
ico:
Apr
il 1,
201
0 to
July
1, 2
015
(NST
-EST
2015
-01)
, Pop
ulat
ion
Estim
ates
Pro
gram
, Pop
ulat
ion
Div
isio
n, U
.S. C
ensu
s Bu
reau
, Dec
embe
r 20
15.
M
edic
aid
Enro
llmen
t —
Dat
a ar
e fr
om T
he K
aise
r Fa
mily
Fou
ndat
ion
Stat
e H
ealth
Fac
ts. D
ata
Sour
ce: C
MS,
Med
icai
d &
CH
IP M
onth
ly
App
licat
ions
, Elig
ibili
ty D
eter
min
atio
ns, a
nd E
nrol
lmen
t R
epor
ts: F
ebru
ary
2014
- S
epte
mbe
r 20
16 (
prel
imin
ary)
, as
of D
ecem
ber
1,
2016
.
L. Recipients And Expenditures
50 2017 Texas HHS Fact Book
1. Federal Medical Assistance Percentages (FMAP), Enhanced Federal Medical Assistance Percentages (EFMAP), By State And Federal Percentages, By
State Fiscal Year and Federal Fiscal Year, 2009-2019.
M. History Of Texas Medicaid Percentage Match
Year Type
State Fiscal Year Federal Fiscal Year
State%
Federal%
State%
Federal %
2009FMAP 40.47 59.53 40.56 59.44
EFMAP 28.32 71.68 28.39 71.61
2010FMAP 41.21 58.79 41.27 58.73
EFMAP 28.85 71.15 28.89 71.11
2011FMAP 39.59 60.41 39.44 60.56
EFMAP 27.72 72.28 27.61 72.39
S T
I M
U L
U S
2009FMAP 31.74 68.26 30.97 69.03
EFMAP 28.32 71.68 28.39 71.61
2010FMAP 29.15 70.85 29.06 70.94
EFMAP 28.85 71.15 28.89 71.11
2011FMAP 32.68 67.33 33.54 66.46
EFMAP 27.72 72.28 27.61 72.39
2012FMAP 41.58 58.42 41.78 58.22
EFMAP 29.11 70.89 29.25 70.75
III — Programs
Notes: • As of January 2013. • EFMAP is the Enhanced Federal Medical Assistance Percentage (CHIP rate). • State Fiscal Year runs from September 1 to August 31. Federal Fiscal Year runs from October 1 to September 30. • Stimulus Assumptions are Tier I Oct 2008-June 2009, Tier II July 2009-Sept 2009, Tier III Oct 2009-Dec 2010. A phased-down 6 month extension from Jan-Jun 2011 is included for FY 2011 as stated in IB 10-33 (August 17, 2010). • State Fiscal Year stimulus rates are based on 11 months stimulus rate in SFY 2009, 12 months 2010 and 10 months 2011. • FFY 2010 rates are final, as stated in Federal Register Vol. 73, No. 229, November 26, 2008. (continued on next page)
2017 Texas HHS Fact Book 51
Year TypeState Fiscal Year Federal Fiscal Year
State %
Federal %
State %
Federal %
2013FMAP 40.79 59.21 40.70 59.30
EFMAP 28.55 71.45 28.49 71.51
2014FMAP 41.26 58.74 41.31 58.69
EFMAP 28.88 71.12 28.92 71.08
2015FMAP 41.9 58.1 41.95 58.05
EFMAP 29.32 70.68 29.36 70.64
2016FMAP 42.79 57.21 42.87 57.13
EFMAP 29.96 70.04 30.01 69.99
2017FMAP 43.74 56.26 43.82 56.18
EFMAP 30.61 69.39 30.67 69.33
2018FMAP 43.18 56.82 43.12 56.88
EFMAP 30.22 69.78 30.18 69.82
2019FMAP 42.66 57.34 42.62 57.38
EFMAP 29.86 70.14 29.83 70.17
III — Programs
Notes: (continued from previous page) • FFY 2011 non-stimulus rates are final as stated in Federal Funds Information for States Issue (FFIS) Issue Brief 09-38, October 21, 2009. • FFY 2012 rates are final, as stated in Federal Register Vol. 75, No. 217, November 10, 2010. •FFY 2013 rates are final, as stated in Federal Register Vol. 76, No. 230, November 30, 2011.• FFY 2014 rates are final, as stated in Federal Register Vol. 77, no 231, November 30, 2012 • FFY 2015 rates are final, as stated in Federal Register Vol. 79, no. 13, January 21, 2014. FFY 2016 rates are final as stated in the FFIS Brief 14-32, October 1, 2014. FFY 2017 rates are final, as stated in Federal Register Vol. 80 no. 227, November 25, 2015. FFY 2018 rates are final, as stated in FFIS Issue Brief 16-49, September 29, 2016. Expenditures in Medicaid and CHIP paid with Title XXI funds will be eligible for an additional 23% point match between Oct 1, 2015 - Sept 30, 2019. FFY 2019 rates are estimated.
1. Federal Medical Assistance Percentages (FMAP), Enhanced Federal Medical Assistance Percentages (EFMAP), By State And Federal Percentages, By
State Fiscal Year and Federal Fiscal Year, 2009-2019 (continued)
M. History Of Texas Medicaid Percentage Match
52 2017 Texas HHS Fact Book
— Notes —
Prepared by
Center for Analytics and Decision SupportPolicy and Performance Division
TexAs HeAlTH AnD HumAn serviCes COmmissiOn
— February 2017 —