Transcript Opportunities to Address Latino Health Disparities in the

Testimony
Senate Finance Committee
SB 1
February 13, 2009
Anne Dunkelberg, Assoc. Director, [email protected]
900 Lydia Street - Austin, Texas 78702
Phone (512) 320-0222 (X102) – www.cppp.org
Impact of Unemployment Growth on Medicaid
and SCHIP and the Number Uninsured
$3.4
1% increase in unemployment also =
a 3-4% decline in state revenues
1.0
1%
1.1
=
Increase in
National
Unemployment
Rate
$1.4 State
Increase in Increase in
Medicaid and Uninsured
SCHIP
(million)
Enrollment
(million)
&
$2.0 Federal
Increase in
Medicaid and
SCHIP Spending
(billion)
Source: Stan Dorn, Bowen Garrett, John Holahan, and Aimee Williams, Medicaid, SCHIP and Economic Downturn: Policy
Challenges and Policy Responses, prepared for the Kaiser Commission on Medicaid and the Uninsured, April 2008
Economic Recovery Package:
• Texas projected to get extra $5.3-$5.7 billion for
Medicaid thru end of 2010-2011 biennium.
– Formula will increase this aid quarterly if state unemployment worsens.
– Maintenance of Effort required (income limits & eligibility policy)
– Investing less than 10% of this in eligibility system improvements and 12month coverage
• helps save our eligibility system,
• helps kids, AND
• BRINGS MORE ENHANCED $$ TO TEXAS
• Assistance for newly unemployed:
– Premium assistance to help unemployed buy COBRA or state
continuation coverage
• SCHIP Reauthorization:
– Eligible for BONUSES if we enroll more MEDICAID kids (“reach
poorest kids first”) and streamline processes
Eligibility Staff Shortage: A Vicious Cycle
15,000
1,000
Recipients per
Worker
12,487
800
Eligibility Staff
782
Staffing
9,000
600
7,136
6,000
400
437
3,000
200
-
1995
1998
2001
2004
2007
Source: Texas Health and Human Services Commission, Data Report for H.B. 3575 Eligibility
System Legislative Oversight Committee, April 2008. Fiscal 2008 are targeted amounts.
Recipients Per Worker
12,000
Texas Medicaid: Who it Helps
July 2007, HHSC data.
Disabled,
359,937
Elderly,
368,135
Poor Parents,
91,838
TANF Parent,
23,263
Children,
1,845,159
Maternity,
96,036
Total enrolled 7/1/2007: 2.79 million
Uninsured Texas Children, 2007
Total: 1.53 million Children
208,000
Over 300%
of poverty
491,000
Below
poverty
339,000
In Texas and
nationwide, the
majority of newlyuninsured children
are in families above
the CHIP upper limit
of 200% of poverty.
200-300% of
poverty
472,000
100-200% of
poverty
Source: U.S. Census
Year-long coverage in Children’s Medicaid —equality with
CHIP policy—would be the single most effective way:
•
•
•
To demonstrate Texans’ commitment to the bipartisan goal of insuring the
poorest uninsured children first.
To increase enrollment of Texas’ eligible uninsured children,
To dramatically cut the costs and workload of our state eligibility workers,
and boost their performance.
12-month coverage will:
• Promote continuity of care and stable medical homes for children, and
ease recruitment and retention of Medicaid doctors & providers.
•
•
•
Help Texas Medicaid meet Frew federal court lawsuit settlement goals for
check-ups, immunizations, and access to care (7.6 months average)
Reduce costs per child: Texas and California studies have found that 12month coverage reduced hospitalizations and the annual cost per child.
12 month continuous eligibility for Children’s Medicaid would dramatically
reduce HHSC’s workload from 3.8 million renewals per year to 1.9 million,
– helping Texas get back into compliance with the Federal law requiring 45 day
application processing, and
– reducing the number of state workers needed to comply with federal law.
Growth of Health Insurance Costs
Growth Index (Base Year is 1996)
2.20
Average Paid by an
Employee for Family
Coverage in Texas
2.00
1.80
Median Family Income
(4-Person Family)
1.60
1.40
1.20
Increase in Poverty
Limit
1.00
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
Source: Georgetown University Center for Children and Families; Medical Expenditure Panel Survey Insurance Component
Tables; U.S. Census Bureau; and U.S. Dept. of Health and Human Services.
Cost of ESI premiums are increasing 10x faster than income.
•
•
In the U.S., premiums for family coverage increased 30% from 2001 to 2005,
while policyholders’ income increased just 3%.
In Texas, premiums for family coverage increased 40% from 2001 to 2005,
while income increased just 3.5%.
Robert Wood Johnson Foundation, April 2008
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900 Lydia Street
Austin, TX 78702
P 512/320-0222 F 512/320-0227