Healthcare in Louisiana & Medicaid Expansion


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Together Baton Rouge's "Civic Academy" analyzing the healthcare crisis in Louisiana and the potential impact of Medicaid Expansion.

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  • Access to health care in the US has become so linked to health insurance that it is literally a matter of life and death.Health insurance is largely linked to your job, more specifically, to the type of job you have.
  • Access to health care in the US has become so linked to health insurance that it is literally a matter of life and death.Health insurance is largely linked to your job, more specifically, to the type of job you have.
  • Access to health care in the US has become so linked to health insurance that it is literally a matter of life and death.Health insurance is largely linked to your job, more specifically, to the type of job you have.
  • Access to health care in the US has become so linked to health insurance that it is literally a matter of life and death.Health insurance is largely linked to your job, more specifically, to the type of job you have.
  • Healthcare in Louisiana & Medicaid Expansion

    1. 1. Healthcare in Louisiana& Medicaid Expansion Civic Academy Series “Education for Action”
    2. 2. Laissez les bon temps rouler!Louisiana has … Great food Mardi Gras Football Friendly people Sportsman’s paradise
    3. 3. But that’s notthe whole story. Not everyone has equal access to the good life here.
    4. 4. State of Health in Louisiana 49th in obesity 46th in diabetes 49th in cancer 45th in infectious disease 49th in low birth weight 49th in infant mortalityAmerican Health rankings United health Foundation 2012 American Health rankings United health Foundation 2012
    5. 5. Our low health access leaves us … 48th in preventable hospitalizations 47th in premature death 49th in overall health outcomes American Health rankings United health Foundation 2012
    6. 6. Louisiana has the 3rd highestuninsured rate in the nation(behind only Texas and Nevada)64,635 uninsured children719,470 uninsured adults785,105 total uninsuredCapacity crowd at tiger stadium. X9
    7. 7. Uninsured rates are high across the entire State. 22% of adults in EBR parish are uninsured 82,000 adults uninsured in metro BR area
    8. 8. Why are so manyLouisiana citizens uninsured? Let’s do the math …Full cost of health insurance $20,000 per year (for family of four)Salary at minimum wage $15,000 per year
    9. 9. 20% of Louisiana families earn belowpoverty level of $22,000 per year. Louisiana has 2nd highest poverty rate in nation after Mississippi. Many LA residents simply can’t afford private health insurance.
    10. 10. This is a matter of life and death.Lack of health insurance … … causes 44,789 excess deaths annually in the US. … caused nearly 17,000 deaths among children between 1988-2005. … causes 13,000 deaths of people aged 55-64 every year. (Expected to exceed 30,000 by 2015.) … is the THIRD leading cause of death among people aged 55-64 (behind only heart disease and cancer) … caused 3,346 deaths of Louisiana residents aged 25-64 between 2005 and 2010.
    11. 11. In the United States,3 people die EVERY HOURdue to a lack of insurance. 4 to 5 people will die during this course of this meeting.
    12. 12. How do poor and workingresidents get healthcare in LA?Charity Hospital SystemBut that system is beingdismantled Statewide.Being replaced bypartnerships with privatehospitals.
    13. 13. How do poor and workingresidents get healthcare in LA? Provide insurance to 1.3 million Louisiana residents. Cover 58% of insured children in LA, 8% of elderly, 15% of adults, 19% of people with disabilities. Medicaid provides nursing care for seniors & serves 250,000 people with disabilities.
    14. 14. Medicaid in Louisiana predominantly serves pregnant women, children and people with disabilities. Very good health outcomes for those groups!But what about other uninsured adults?
    15. 15. LA Medicaid has among most narrow eligibility rules in the nation …Only covers adults earning below about $2,700 per year (that’s not a typo) (12% of the poverty level of $22,500)
    16. 16. We have an opportunity to change this Medicaid Expansion
    17. 17. So what is Medicaid Expansion?Part of the Affordable Care Act. Encourages states to offer Medicaid to adults earning up to 133% of poverty line. That’s up to about $30,000 per year (for family of 4)vs. current cutoff of about $2,700 per year.
    18. 18. Supreme Court ruled it must be optional for states.At this time, Governor Jindal has NOT YETACCEPTED Medicaid Expansion.
    19. 19. What would Medicaid Expansiondo for Louisiana?Provide health insurance toabout 400,000 LA residents. (That’s more than 4 Tiger Stadiums of LA citizens)
    20. 20. Louisiana Budget Project (2013).
    21. 21. What ELSE would MedicaidExpansion do for Louisiana? Bring $15.8 billion to the Louisiana economy over 10 years. Create approximately 15,600 new jobs in Louisiana in 2016 alone. “Louisiana’s Economy Will Benefit from Expanding Medicaid”, Families USA & Louisiana Consumer Healthcare Coalition (2013).
    22. 22. Positive outcomes of acceptingMedicaid Expansion• People engage in more preventive healthcare.• People access healthcare earlier, preventing worse outcomes.• MONEY SAVED because fewer people go to emergency rooms.• People with better health miss less work.
    23. 23. How much would Medicaid expansion cost Louisiana?Feds pay 100% of expansioncosts for first 3 years. Feds pay 90% of expansion costs after 10 years. Every $1 in State funding brings $9 in federal funding.
    24. 24. How much would Medicaid expansion cost Louisiana?Maximum Estimate: $1 billion over 10 years.Is that a lot? State cost for each newly insured citizen: $250 per year! Other estimates indicate it would cost the state ZERO, due to savings from having fewer uninsured.
    25. 25. Where to get the money?First 3 years are fully funded by Fed Gov.After that, total needed is about $100m per year. $1.25 cigarette tax $278 million per year. would raise … Enough to fund ALL of Medicaid expansion (and then some)
    26. 26. Current Louisiana cigarette 49th among all tax is 36 cents US States A coincidence?Louisiana’s cancer mortality rate 49th among all US States
    27. 27. Smoking Frequency See any patterns? Cancer mortality
    28. 28. Annual healthcare expenditures inLouisiana directly caused by tobacco use: $1.47 billion PER YEAR Smoking-caused State Medicaid program spending: $663 million PER YEAR American Cancer society (2012)
    29. 29. Other benefits of raising cigarette tax38,900 current adult smokers would quit.21,900 LA residents would be saved from smoking caused deaths. 30,7000 kids won’t become addicted to smoking.
    30. 30. What are the consequences of NOT accepting Medicaid Expansion? 400,000 LA residents would remain uninsured. 44,000 currently insured residents in New Orleans would lose their coverage.
    31. 31. What are the consequences of NOT accepting Medicaid Expansion? Louisiana would lose out on $15.8 billion in federal funding LA hospitals lose out on hundreds of millions. Could bankrupt new hospital in New Orleans.
    32. 32. What are the consequences of NOT accepting Medicaid Expansion? People will Compared to the uninsured, people with Medicaid have a 6% die! LOWER DEATH RATE. How much is a human Is it worth $250? life worth?New England Journal of Medicine (2012)
    33. 33. Who is for Medicaid Expansion?American Medical AssociationAmerican Hospital AssociationAARPAmerican Academy of Family PhysiciansLouisiana Primary Care AssociationUS Conference of Catholic BishopsNearly all major religious denominations.
    34. 34. Who ELSE is for Medicaid Expansion?American Cancer Society Cancer Action Network, Inc. AARP Acadiana CARES Advocacy Center Advocates forLouisiana Public Healthcare Belle Reve Bienville House Brotherhood, Incorporated Capitol City Family HealthCenter Center for Health Law and Policy Innovation, Harvard Law School Childrens Bureau of New OrleansCitizens United for In-Home Support Classic Homes & Services, Inc. Connect to Protect Council on Alcohol & DrugAbuse for Greater New Orleans Crescent City Media Group Doctors for America Greater New Orleans AmericanAssociation of University Women Greenlight Operations Gulf Coast Environmental and Health Coalition HealthLaw Advocates of Louisiana HOPE for the Homeless Independent Womens Organization Integrative Consulting, IncInterfaith Sponsoring Committee jacobs family medical clinic LA NOW LA Primary Care Assoc Liberty HeightsCommunity Cente Louisiana AIDS Advocacy Network Louisiana Alliance of Direct Support Professionals LouisianaAssociation of Nonprofit Organizations Louisiana Budget Project Louisiana Center for Health Equity LouisianaConsumer Healthcare Coalition Louisiana Federation of Families for Childrens Mental Health, Inc. LouisianaHousing Alliance Louisiana Latino Health Coalition for HIV/AIDS Awareness (LLHC) Louisiana Primary CareAssociation Louisiana Progress Louisiana Supported Living Network Louisiana Trans Advocates LouisianaWomens Network Marillac Community Health Center Mental Health America of Louisiana Mid South Division/National Association of Social Workers, LA Chapter New Orleans Chapter of NOW New Orleans Chapter of NOWNew Orleans Medical Association New Orleans Medical Association New Orleans Regional AIDS Planning Council(NORAPC) New Orleans Society for Infectious Disease Awareness (NOSIDA) New Orleans Society Infectious DiseaseAwareness (NOSIDA) NO/AIDS Task Force NOELA Community Health Center Northshore Democratic WomensClub One Voice Louisiana Priority Health Care, Inc. St. Landry Democratic Parish Executive Committee ThePhiladelphia Center The Truth Campaign Tulane T-Cell Clinic UNITY of Greater New OrleansWomen With a Vision
    35. 35. What’s Governor Jindal’s position?Governor says he wants “flexibility” on 5 points:1) “Eligibility process should be simple, accurate and fair”2) “States must be allowed to set reasonable premiums andcopays”3) “Flexibility on eligibility levels and program design”4) “Streamline funding and waiver process & accountabilitytied to health outcomes”5) “Flexibility to prevent undermine of the private insurancemarket as was done with SCHOP program”
    36. 36. Other states have WON flexibilityArizona accepted Medicaid expansion, with a triggerto pull out if federal match ever went below 90%.Florida won approval to run expanded Medicaidthrough private managed care.Arkansas won approval to use Medicaid expansionfunding to subsidize families below 133% of povertybuying insurance through healthcare exchanges.
    38. 38. Medicaid Expansion is not apanacea…Low reimbursement rates for providers canlead to shortages (especially for specialists)Limited choices for drugs and procedures.Problems with access.
    39. 39. But it is the most significant thingour state can do now to improve the health of our citizens.