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Lbp rationale for_medicaid_expansion_in_louisiana


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Lbp rationale for_medicaid_expansion_in_louisiana

  1. 1. Medicaid Expansion is Right Choice for LouisianaSteve SpiresLouisiana Budget
  2. 2. About Louisiana Budget ProjectProvides independent, nonpartisan research andanalysis of public policy issues and their impacton low- and moderate-income Louisiana families Visit
  3. 3. Health reform is needed• 1 in 4 non-elderly adults in Louisiana is uninsured• LA has some of the strictest Medicaid eligibility for adults in the nation, income limit around 15 percent FPL —or less than $3,000 a year for a family of three• Employer-sponsored insurance coverage has been declining for years• Only 5 percent of children are uninsured due to success of LaCHIP (we know that Medicaid expansions work)
  4. 4. Eligibility is generous for children and pregnant women. Could be expanded for adults in 2014250% Medicaid expansion eligibility:200% $14,850 for an individual $25,390 for a family of three150%100%50% 0% Children Pregnant Parents Adults People with Nursing Women without Disabilities Home/ Long Children Term Care Current Eligibilty (as % of Federal Poverty Level) 2014 Expansion up to 133% FPL
  5. 5. Key Findings from Our Research• Of estimated 330,000 uninsured people who would qualify for Medicaid expansion, the majority—200,000—are working• Major coverage gains in important economic sectors: construction, entertainment/tourism and retail• Other results: major gains among health care and child care employees
  6. 6. Medicaid Expansion is Critical for Low-Income Working People Where Do Uninsured Louisianans Who Could Gain Medicaid Coverage Work? Restaurants and Food Service 33,900 Construction 24,300 Grocery Stores 8,400 Nursing Homes 6,300 Hotels and Motels 6,100 Landscaping Services 6,000 Professional Building Services 4,450 Elementary and Secondary Schools 4,400 Home Health Care Providers 4,100 Hospitals 4,050
  7. 7. Medicaid Expansion is Critical for Low-Income Working People Occupations w/ Average Wages That Could Make a Family Eligible for Medicaid Expansion (Source: Louisiana Workforce Commission) Occupation Avg. Hourly Wage Annual Full Time Wage Child Care Worker $9.00 $18,730 Construction Laborer $12.80 $26,600 Hairdresser $12.00 $24,920 Home Health Aide $9.30 $19,380 Hotel Desk Clerk $9.40 $19,530 Landscaper $10.85 $22,570 Maid/Housekeeper $8.80 $18,340 Restaurant Cook $10.60 $22,060 Retail Salesperson $11.10 $23,110 Waiter/Waitress $9.10 $18,990
  8. 8. Expansion = More Health Security• More than 50,000 uninsured Louisianans who would be expansion eligible were working in the last few years— many are unemployed due to the still weak economy. Louisianas Unemployment Rate Number of Uninsured Adults9.0 750,0008.0 730,0007.06.0 710,0005.04.0 690,0003.0 670,0002.01.0 650,0000.0 630,000 2008 2009 2010 2011
  9. 9. Medicaid expansion will benefit Louisianans in every parishShreveport Monroe Alexandria Baton Rouge Lake Charles New Orleans Lafayette
  10. 10. Medicaid Expansion is a GOOD DEAL!• Federal government will pay 100% of the cost for the first three years• State will slowly chip in after that, but never have to pay more than 10% of the cost• By comparison, today the feds pay for around 65% of Louisiana’s Medicaid program, with the state responsible for 35%
  11. 11. State cost has been exaggerated• Jindal administration is often quoted saying expansion will cost $3.7 billion over 10 years• More credible estimates closer to $1 billion• Actual cost is much lower, as there will be offsetting savings due to reform• In return, Louisiana will receive $15.8 billion in new federal money through 2022
  12. 12. We are already paying• Louisiana already spends hundreds of millions each year on health care for the uninsured. So do private and non-profit providers• Families and businesses with private insurance pay higher premiums due to “cost shifting”• Reform will improve the health care system and result in some savings that can be used to help cover the cost of Medicaid expansion
  13. 13. Positive Health Impacts• Louisiana ranks near the bottom on national health indicators• Medicaid expansion would improve access to care, reduce financial stress on families and result in better overall well-being• New research shows that Medicaid expansions even reduce state mortality rates
  14. 14. Positive Economic Impacts• Medicaid currently supports an estimated 50,000 health-care jobs and thousands more “indirect” jobs across the state• Influx of new federal health-care dollars will stimulate state economy, create jobs and generate additional state revenue• Expansion means a more competitive market for health care services
  15. 15. Direct Benefits for Employers• Healthier workforce is a more productive workforce• Access to insurance results in fewer missed days of work and better health management for employees• Less “job lock” means more efficient labor market and better employees
  16. 16. Keeping the cost in perspective• Louisiana already pays for high cost care for the uninsured• Reform will bring significant health care savings elsewhere in the state budget that can be used to pay for most of Medicaid expansion• Medicaid expansion will also result in new economic activity that will generate additional state revenues
  17. 17. Favorable timeline for Louisiana• The state won’t have to pay ANY expansion costs for the first 3 years. By 2017: • State revenues will likely have increased due to economic growth • State will have a clear idea of the costs and savings and can plan accordingly • The state always reserves the right to “opt out” in the future if needed
  18. 18. What is the alternative?• Dollars that the state currently use to fund public hospitals and care for the uninsured are going away• Without federal Medicaid expansion dollars, providers may not get paid, clinics could close and patients will be harmed• Accepting Medicaid expansion revenue is the responsible path forward
  19. 19. We can’t afford to NOT expand MedicaidThe need for Medicaid expansion is clear. Without expansion:• Poor health outcomes will continue to affect our workforce and diminish productivity• High cost of uninsured care will increase financial pressure on the state and health care providers• Continued “cost shifting” will affect those with private insurance