Download - Medicaid Coverage and Spending
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Medicaid Coverage and Spending
Diane Rowland, Sc.D.Executive Vice President,
Henry J. Kaiser Family Foundationand
Executive Director,Kaiser Commission on Medicaid and the Uninsured
forAlliance for Health Reform Briefing:
Inside Deficit Reduction: What it Means for MedicaidWashington, DC
November 10, 2011
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FIGURE 2
Total = 300 million
Health CoverageOther Government
Programs4%
Total = $2.1 trillion
Health Spending
SOURCE: Health insurance coverage: KCMU/Urban Institute analysis of 2009 ASEC Supplement to the CPS. Health expenditures: KFF calculations using NHE data from CMS, Office of the Actuary
Health Care Coverage and Personal Health Care Expenditures in the U.S., 2009
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FIGURE 3
Medicaid has many roles in our health care system.
Health Insurance Coverage
29 million children & 15 million adults in low-income families; 15 million elderly and persons with
disabilities
State Capacity for Health Coverage
Federal share can range from 50 - 83%;For FFY 2012, ranges from 50 - 74.2%
MEDICAID
Support for Health Care System and Safety-net
16% of national health spending; 40% of long-term care services
Assistance to Medicare Beneficiaries
8.9 million aged and disabled — 21% of Medicare beneficiaries
Long-Term Care Assistance
1 million nursing home residents; 2.8 million
community-based residents
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FIGURE 4
Most beneficiaries are children, but the elderly and disabled account for the majority of Medicaid spending.
NOTE: Percentages may not add up to 100 due to rounding.SOURCE: KCMU/Urban Institute estimates based on data from FY 2008 MSIS and CMS Form-64, 2010.
Total = 59.5 million Total = $317.7 billion
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FIGURE 5
Disability and long-term care drive higher per-enrollee spending.
SOURCE: Kaiser Commission on Medicaid and the Uninsured and Urban Institute estimates based on 2007 MSIS and CMS64 data.
$2,135 $2,541
$14,481
$12,499Long-Term Care
Acute Care
$5,163
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FIGURE 6
Duals Account for 39% of Medicaid Spending.
SOURCE: Urban Institute estimates based on FFY 2007 data from MSIS and CMS Form 64, prepared for the Kaiser Commission on Medicaid and the Uninsured, 2010.
Total = 58 Million
Medicaid Enrollment Medicaid Spending
Total = $311 Billion
Duals 15%
Children 50%
Other Aged & Disabled
10%
Adults 25%
Non-Dual Spending
60%Long-Term Care 27%
Prescribed Drugs 0.4%
Premiums 4% Medicare
Acute 6%
Other Acute
2%
Dual Spending
39%
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FIGURE 7
Medicaid spending growth per enrollee has been slower than growth in private health spending.
SOURCE: Urban Institute, 2010. Estimates based on data from Medicaid Financial Management Reports (HCFA/CMS Form 64), Medicaid Statistical Information System (MSIS), and KCMU/HMA enrollment data. Expenditures exclude prescription drug spending for dual eligibles to remove the effect of their transition to Medicare Part D in 2006.
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FIGURE 8
Enrollment was the largest driver of Medicaid spending during this last recession.
SOURCE: Urban Institute, 2010. Estimates based on data from Medicaid Financial Management Reports (HCFA/CMS Form 64), Medicaid Statistical Information System (MSIS), and KCMU/HMA enrollment data. Expenditures exclude prescription drug spending for dual eligibles to remove the effect of their transition to Medicare Part D in 2006.
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FIGURE 9
WY
WI
WV
WA
VA
VT
UT
TX
TN
SD
SC
RI PA
OR
OK
OH
ND
NC
NY
NM
NJ
NH
NV NE
MT
MO
MS
MN
MI
MA
MD
ME
LA
KY KS
IA
IN IL
ID
HI
GA
FL
DC
DE
CT
CO CA
ARAZ
AK
AL
NOTE: Rates are rounded to nearest percent. These rates will be in effect Oct. 1, 2011 – Sept. 30, 2012.SOURCE: Federal Register,, Nov, 10, 2010 (Vol. 75, No. 217), pp. 69082-69083. http://edocket.access.gpo.gov/2010/pdf/2010-28319.pdf
Federal share of Medicaid spending (FMAP) varies by state.
60 – 66 percent (13 states)51 – 59 percent (11 states)50 percent (15 states)
67 – 74 percent (12 states including DC)
Statutory Federal Medical Assistance Percentages , FY 2012