ITUP Teaser Slides
www.itup.org
Just the Facts:
Coverage in the US & California
2/10/10
Prepared by Serina Reckling and Sa...
Per Capita Total Current Health Care Expenditures,
U.S. and Selected Countries, 2007
$2,851
$4,417
$3,180
$2,578
$4,463
$3...
10.4%
12.7%
8.5%
7.7%
6.4%
1.3%
2.9%
6.3%
7.9%
6.3%
7.5%
9.3%
5.6%
4.3%
3.2%
0.2%
-0.6%
3.0%
5.4%
6.6%
2001 2002 2003 2004...
4%
11%
2%3% 4%
1%
52%
30%
24%
14%
10% 10%
Medicaid Private Uninsured
Percent Reporting:
Adults Adults Children
No Usual
So...
Decrease in
Employer
Sponsored
Insurance
(million)
2.8%
National
Unemployment
Rate Increase
since 2008
(from 7.2% in
Dec-0...
Private Non-
group
5%
Uninsured
17%
Medicaid/
Other Public
18%
Employer-
sponsored
I nsurance
60%
Health Insurance Coverag...
Nonelderly’s Health Insurance
Coverage by Family Poverty Level,
2008
20%
89%
45%
29%
12%
5%
42%
71%
6%
18%
29%
35%
Private...
• 8 out of 10 of the uninsured are in
working families & don’t have access to
employer-sponsored health insurance
• In 200...
Characteristics of the Uninsured,
2008
400% FPL
and Above
10%
200-399% FPL
23%
100-199% FPL
29%
< 100% FPL
38%
Family Inco...
Nearly 70% of the uninsured with mental healthNearly 70% of the uninsured with mental health
disorders do not have access ...
• In 2007, 5 million uninsured children
were eligible for public coverage but
were not enrolled
• 55% of low-income parent...
Source: The Kaiser Family Foundation. Five Basic Facts on the
Uninsured. September 2009.
Cumulative Changes in Health Insurance Premiums,
Inflation, and Workers’ Earnings, 1999-2009
131%
38%
28%
0%
20%
40%
60%
8...
Average Health Insurance Premiums and
Worker Contributions for Family Coverage, 1999-2009
$4,247
$9,860
$1,543
$3,515
1999...
Uninsured Rates Among Part-Time Students and Non-Students
Ages 19–23 Are About Twice That of Full-Time Students
* Other in...
Nineteenth Birthdays Are Critical Turning Points in
Coverage for Young Adults (Percent Uninsured)
Children,
Age 18 and Und...
More Than Half of Young Adults Are Overweight or Obese,
Two of Five Report Binge Drinking or Smoke Cigarettes,
and 15 Perc...
Adults ages 19–64 with
individual coverage or
who tried to buy it in
past three years who: Total
Health
problem
No health
...
State Number of
Uninsured
CaliforniaCalifornia 6.6 million6.6 million
Texas 5.6 million
Florida 3.7 million
Arizona 1.2 mi...
Uninsured Workers, by Employer Size and Type
California Residents, Ages 18 to 64, 2008
Source: Employee Benefit Research I...
0%
10%
20%
30%
40%
50%
60%
70%
80%
1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 20...
Likelihood of Workers Being Uninsured by Employer Size and
Type
U.S. vs California 2008
Source: California Healthcare Foun...
California vs. US
Uninsured (2009)
National Comparison CA US
Number of Uninsured (in millions) 6.7 45.7
Adults (ages 18 to...
Uninsured Californians, 2008
Age Ethnicity
Source: Employee Benefit Research Institute estimates of the Current Population...
COST/(SAVINGS) ELEMENT
FY 2018-19
SENATE VERSION (H.R. 3590)
Patient Protection and Affordable Care Act
Total Funds Genera...
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  • Medicaid spending and enrollment growth reached low-points in state fiscal years 2006 and 2007, but increases in 2008 are projected as states address enrollment barriers and expand coverage to the growing number of uninsured.
  • ARE BOTH ADULTS AND KIDS FROM KFF/COMMONWEALTH SURVEY?
    MAKE SURE IT’S ALL INCOMES, NOT ONLY LOW-INCOME
  • Job losses since 2008 have led to an estimated 6.9 million fewer Americans receiving health coverage through the workplace, and an accompanying projected rise of 2.8 million in Medicaid enrollment and 3.0 million in the nation&amp;apos;s uninsured.
  • Deleted “Data may not total 100% due to rounding.”
  • Premiums for employer-sponsored health insurance have risen from $5,791 in 1999 to $13,375 in 2009, with the amount paid by workers rising by 128%.
  • removing house portion because senate will be used,
  • .ppt

    1. 1. ITUP Teaser Slides www.itup.org Just the Facts: Coverage in the US & California 2/10/10 Prepared by Serina Reckling and Sara Watson
    2. 2. Per Capita Total Current Health Care Expenditures, U.S. and Selected Countries, 2007 $2,851 $4,417 $3,180 $2,578 $4,463 $3,527 $2,569 $3,295 $3,319 $2,626 $3,463 $3,496 $2,677 $3,362 $3,715 $3,462 $3,581 $3,172 $6,956 $0 $1,000 $2,000 $3,000 $4,000 $5,000 $6,000 $7,000 $8,000 United States United Kingdom Switzerland^ Sweden Spain Norway Netherlands^ Italy Ireland Iceland* Greece Germany France Finland Denmark Canada Belgium^ Austria Australia ^OECD estimate. *Differences in methodology. Notes: Amounts in U.S.$ Purchasing Power Parity, see www.oecd.org/std/ppp; includes only countries over $2,500. OECD defines Total Current Expenditures on Health as the sum of expenditures on personal health care, preventive and public health services, and health administration and health insurance; it excludes investment. Source: Organisation for Economic Co-operation and Development. OECD Health Data 2009, from the SourceOECD Internet subscription database updated November 2009. Copyright OECD 2009, http://www.oecd.org/health/healthdata. Data accessed on 11/13/2009.
    3. 3. 10.4% 12.7% 8.5% 7.7% 6.4% 1.3% 2.9% 6.3% 7.9% 6.3% 7.5% 9.3% 5.6% 4.3% 3.2% 0.2% -0.6% 3.0% 5.4% 6.6% 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Medicaid Spending Grow t h Medicaid Enrollm ent Grow t h Projected Percent Change in Medicaid Spending and Enrollment, FY 2001-2009 NOTE: Enrollment percentage changes from June to June of each year. Spending growth percentage changes in state fiscal year. SOURCE: Enrollment Data for 1998-2006: Medicaid Enrollment in 50 States, KCMU. Spending Data from KCMU Analysis of CMS Form 64 Data for Historic Medicaid Growth Rates. FY 2009 and FY 2010 data based on KCMU survey of Medicaid officials in 50 states and DC conducted by Health Management Associates, September 2009.
    4. 4. 4% 11% 2%3% 4% 1% 52% 30% 24% 14% 10% 10% Medicaid Private Uninsured Percent Reporting: Adults Adults Children No Usual Source of Care Needed Care but Did Not Get It Due to Cost * Children Access to Care: Medicaid Comparable to Private Insurance; Uninsured, not so much * In the past 12 months NOTE: Respondents who said usual source of care was the emergency room were included among those not having a usual source of care SOURCE: KCMU analysis of 2008 NHIS data
    5. 5. Decrease in Employer Sponsored Insurance (million) 2.8% National Unemployment Rate Increase since 2008 (from 7.2% in Dec-08 to 10.0% in Nov-09) = 2.8 3.0 Medicaid /CHIP Enrollment Increase (million) Uninsured Increase (million) & 6.9 Note: Totals may not sum due to rounding and other coverage. Source: Based on John Holahan and Bowen Garrett, Rising Unemployment, Medicaid, and the Uninsured, prepared for the Kaiser Commission on Medicaid and the Uninsured, January 2009. Impact of the Rise in Unemployment on Health Coverage, 2008 to 2009
    6. 6. Private Non- group 5% Uninsured 17% Medicaid/ Other Public 18% Employer- sponsored I nsurance 60% Health Insurance Coverage of the Nonelderly Population, 2008 262.8 Million SOURCE: Kaiser Commission on Medicaid and the Uninsured/Urban Institute analysis of 2009 ASEC Supplement to the CPS.
    7. 7. Nonelderly’s Health Insurance Coverage by Family Poverty Level, 2008 20% 89% 45% 29% 12% 5% 42% 71% 6% 18% 29% 35% Private Medicaid/ Public Uninsured 50.2 M 46.0 M 41.5 M 125.1 M Number Under 100% 100% - 199% 200% - 299% 300% + NOTES: Data may not total 100% due to rounding. The Federal Poverty Level for a family of four in 2008 was $22,025 (according to the U.S. Census Bureau’s poverty threshold). Family size and total family income are grouped by insurance eligibility. SOURCE: Kaiser Commission on Medicaid and the Uninsured/Urban Institute analysis of 2009 ASEC Supplement to the CPS.
    8. 8. • 8 out of 10 of the uninsured are in working families & don’t have access to employer-sponsored health insurance • In 2005, ¾ of uninsured workers were adults not offered employer-sponsored coverage • Since 2002, the number of firms offering employer-sponsored health insurance has decreased from 69% to 60% Source: The Kaiser Family Foundation. Five Basic Facts on the Uninsured. September 2009.
    9. 9. Characteristics of the Uninsured, 2008 400% FPL and Above 10% 200-399% FPL 23% 100-199% FPL 29% < 100% FPL 38% Family IncomeFamily Work Status Total = 45.7 million uninsured 1 or More Full- Time Workers 66% No Workers 19% Part-Time Workers 14% Age 55-64 9% 30-54 43% 19-29 30% 0-18 18% The federal poverty level was $22,025 for a family of four in 2008. Data may not total 100% due to rounding. SOURCE: KCMU/Urban Institute analysis of 2009 ASEC Supplement to the CPS.
    10. 10. Nearly 70% of the uninsured with mental healthNearly 70% of the uninsured with mental health disorders do not have access to the services theydisorders do not have access to the services they needneed Source: The National Council for Community Behavioral Health Care. Unmet Healthcare Needs of Indigent, Uninsured Americans. July 2009.
    11. 11. • In 2007, 5 million uninsured children were eligible for public coverage but were not enrolled • 55% of low-income parents do not know how to enroll their child • 45% do not think their child is eligible for coverage • 50% think the enrollment process is difficult Source: Kenney, Genevieve. Uninsured and Eligible for Public Coverage: Underlying Causes and Policy Solutions. National Institute for Health Care Management. November 2009.
    12. 12. Source: The Kaiser Family Foundation. Five Basic Facts on the Uninsured. September 2009.
    13. 13. Cumulative Changes in Health Insurance Premiums, Inflation, and Workers’ Earnings, 1999-2009 131% 38% 28% 0% 20% 40% 60% 80% 100% 120% 140% 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 Health Insurance Premiums Workers' Earnings Overall Inflation Note: Due to a change in methods, the cumulative changes in the average family premium are somewhat different from those reported in previous versions of the Kaiser/HRET Survey of Employer-Sponsored Health Benefits. See the Survey Design and Methods Section for more information, available at http://www.kff.org/insurance/7936/index.cfm. Source: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 1999-2009. Bureau of Labor Statistics, Consumer Price Index, U.S. City Average of Annual Inflation (April to April), 1999-2009; Bureau of Labor Statistics, Seasonally Adjusted Data from the Current Employment Statistics Survey, 1999-2009 (April to April).
    14. 14. Average Health Insurance Premiums and Worker Contributions for Family Coverage, 1999-2009 $4,247 $9,860 $1,543 $3,515 1999 2009 Employer Contribution W orker ContributionNote: The average worker contribution and the average employer contribution may not add to the average total premium due to rounding. Source: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 1999-2009. $5,791 128% Worker Contribution Increase 131% Premium Increase $13,375
    15. 15. Uninsured Rates Among Part-Time Students and Non-Students Ages 19–23 Are About Twice That of Full-Time Students * Other includes Medicare, Medicaid, and Military. ** Includes part-time students and non-students. Source: Analysis of the March 2008 Current Population Survey by S. Glied and B. Mahato of Columbia University for The Commonwealth Fund. Not full-time students** = 12.4 million Full-time students = 7.8 million Own-employer 7% Employer- dependent 48% Individual or college plans 19% Other* 8% Uninsured 18% Other* 14% Employer- dependent 15% Own- employer 26% Individual or college plans 7% Uninsured 37%
    16. 16. Nineteenth Birthdays Are Critical Turning Points in Coverage for Young Adults (Percent Uninsured) Children, Age 18 and Under Young Adults, Ages 19–29 Total 11% 29% <100% FPL 19 51 100%–199% FPL 16 40 >200% FPL 7 16 Source: Analysis of the March 2008 Current Population Survey by S. Glied and B. Mahato of Columbia University for The Commonwealth Fund.
    17. 17. More Than Half of Young Adults Are Overweight or Obese, Two of Five Report Binge Drinking or Smoke Cigarettes, and 15 Percent Have a Chronic Health Condition Percent of young adults with the following health problems: 1 Data from 2005–2006; ages 18–29. 2 Binge drinking defined as ‘drinking five or more drinks on the same occasion on at least one day in the past 30 days’; data from 2006; ages 18–25. 3 Data from 2006; ages 18–25. 4 Data from 2003–2004; women ages 20–29. 5 Any chronic condition includes physician-diagnosed arthritis, asthma, cancer, diabetes, heart disease, or hypertension; data from 2004–2006; ages 18–29. 6 Mental disorders include major depression, generalized anxiety disorder, and panic disorder; data from 1999–2004; ages 20–29. 7 Data from 2004–2006; ages 18–29. Source: National Center for Health Statistics, “Health, United States, 2008” (Hyattsville, Md.: NCHS, 2009). 1 2 3 4 5 6 7
    18. 18. Adults ages 19–64 with individual coverage or who tried to buy it in past three years who: Total Health problem No health problem <200% FPL* 200%+ FPL* Found it very difficult or impossible to find coverage they needed 47% 60% 35% 52% 40% Found it very difficult or impossible to find affordable coverage 57 70 45 63 53 Were turned down, charged a higher price, or excluded because of a preexisting condition 36 47 26 39 34 Never bought a plan 73 79 66 85 62 The Individual Insurance Market Is Not an Affordable Option for Many People * FPL = federal poverty level. Source: Commonwealth Fund Biennial Health Insurance Survey (2007).
    19. 19. State Number of Uninsured CaliforniaCalifornia 6.6 million6.6 million Texas 5.6 million Florida 3.7 million Arizona 1.2 million California has the 8th highest percent of uninsured residents in the nation: 20.5% State Comparison of the Uninsured, 3-Year Average, 2006 to 2008* Source: California Healthcare Foundation, 2009 California’s Uninsured
    20. 20. Uninsured Workers, by Employer Size and Type California Residents, Ages 18 to 64, 2008 Source: Employee Benefit Research Institute estimates of the Current Population Survey, March 2009 Supplement. Medically Indigent Adults (MIAs)
    21. 21. 0% 10% 20% 30% 40% 50% 60% 70% 80% 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 70.1% 64.6% 17.6% 13.7% 61.1% 55.6% 20.6% 17.4% CA CA U.S. U.S. Employer-basedCoverage UninsuredPopulation Employer-based Coverage and Uninsured Population Trends California vs. U.S. 1987-2008 Source: California Healthcare Foundation, 2009
    22. 22. Likelihood of Workers Being Uninsured by Employer Size and Type U.S. vs California 2008 Source: California Healthcare Foundation, 2009
    23. 23. California vs. US Uninsured (2009) National Comparison CA US Number of Uninsured (in millions) 6.7 45.7 Adults (ages 18 to 64) 5.7 38.4 Children (up to age 18) 1.0 7.3 Sources of Coverage Uninsured 20.6% 17.4% Employer-based 55.6% 61.1% Public Programs (Medi-Cal, Healthy Families, Medicare, and Tricare/CHAMPVA) 19.9% 19.4% Individually Purchased 7.7% 6.3% Source: California Healthcare Foundation
    24. 24. Uninsured Californians, 2008 Age Ethnicity Source: Employee Benefit Research Institute estimates of the Current Population Survey, March 2009 Supplement.
    25. 25. COST/(SAVINGS) ELEMENT FY 2018-19 SENATE VERSION (H.R. 3590) Patient Protection and Affordable Care Act Total Funds General Funds Eligibility expansion (MIAs and Parents) $ 6,815,000 $ 1,338,000 Healthy Families Shift (to Medi-Cal) 648,000 324,000 Coverage of eligible but unenrolled (Medi-Cal and Healthy Families) 1,400,000 700,000 Exchange coverage subsidies $11,130,000 Administrative Costs (Ongoing) 16,000 8,000 Direct Costs (Savings) (636,000) (425,000) Bright Line (Savings) (954,000) (477,000) State Program (Savings) (1,435,000) (608,000) County Program (Savings) ($1,440,000 Federal Reform Dividend for CA $16,984,000 ($580,000) Outpatient rate increase (80% of Medicare) 4,318,000 1,974,000 Primary care rate increase (80% of Medicare) 537,000 255,000 (Dollars in Thousands) HEALTH CARE REFORM COST AND SAVINGS ESTIMATE FULL IMPLEMENTATION: CALIFORNIA

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