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  1. 1. Section 5: Public Health Insurance Programs <ul><li>Medicare </li></ul><ul><li>Medical Assistance (Medicaid) </li></ul><ul><li>MinnesotaCare </li></ul><ul><li>General Assistance Medical Care (GAMC) </li></ul><ul><li>Minnesota Comprehensive Health Association (MCHA) </li></ul>
  2. 2. Medicare A federal health insurance program for people age 65 or older and people with certain disabilities and end-stage renal disease.
  3. 3. Medicare Enrollment and Spending, Minnesota and the U.S., 1997 to 2007 Sources: Enrollment data from Centers for Medicare and Medicaid Services (CMS) as of July 1 each year; 2007 enrollment data are County estimates for MN and US; Spending estimates by federal fiscal year from the U.S. Census Bureau, Consolidated Federal Funds Report with an MDH adjustment for border crossing; 2007 spending estimates are based on a straight line trend between 2006 and 2008 for MN with an MDH adjustment for border crossing. $8,060 $5,724 $349,094 $4,053 43,313,626 708,081 2006 $7,138 $5,078 $300,089 $3,486 42,040,460 686,522 2004 $7,877 $5,648 $335,915 $3,902 42,643,432 690,792 2005 $8,493 $5,979 $374,820 $4,352 44,132,245 727,938 2007 Spending per Enrollee Expenditures ($ millions) Enrollment $6,670 $4,709 $274,054 $3,184 41,086,981 676,156 2003 $6,202 $4,400 $251,117 $2,937 40,488,878 667,407 2002 $5,928 $4,179 $237,269 $2,760 40,025,724 660,399 2001 $5,444 $3,834 $215,689 $2,509 39,619,986 654,405 2000 $5,331 $3,748 $208,648 $2,430 39,140,386 648,272 1999 $5,396 $3,792 $209,509 $2,442 38,824,855 643,877 1998 $5,388 $3,778 $207,156 $2,415 38,444,739 639,293 1997 U.S. MN U.S. MN U.S. MN FY
  4. 4. Medicare Beneficiaries with Dual Coverage, 2007 Sources: Minnesota Department of Human Services, data for state fiscal year 2007; Medicare enrollment data from Centers for Medicare and Medicaid Services as of July 1, 2007
  5. 5. Minnesota’s Medicare Enrollment as Percent of Population, by Region, 2007 For the regional boundaries, see slide 39 at the end of this chartbook. Sources: Centers for Medicare and Medicaid Services, enrollment by county as of July 1, 2007; U.S. Census Bureau, Population Estimates for Minnesota Counties for July 1, 2007
  6. 6. Statewide Distribution of Medicare Enrollees, by Region, 2007 For the regional boundaries, see slide 39 at the end of this chartbook. Source: Minnesota Department of Human Services. Enrollment data for fiscal year 2007; U.S. Census Bureau, Population Estimates of Minnesota Counties for July 1, 2007
  7. 7. Sources of Medicare Supplemental Insurance Coverage in Minnesota, 2007 Source: Minnesota Department of Health, Health Economics Program, Minnesota Health Access Survey, 2007
  8. 8. Sources of Medicare Supplemental Insurance Coverage, Minnesota and U.S. Sources: Minnesota Department of Health, Health Economics Program, Minnesota Health Access Survey 2007; CMS, Medicare Current Beneficiary Survey, preliminary data for 2006
  9. 9. Types of Prescription Drug Coverage for Medicare Enrollees, Minnesota and U.S., 2008 <ul><li>Medicare Part D Prescription Drug Coverage: </li></ul>Source: Centers for Medicare and Medicaid Services (CMS) enrollment data as of January 18, 2008. *Includes beneficiaries who were auto-enrolled and additional beneficiaries receiving the low-income subsidy. ^Includes enrollees in Federal Employee Health Benefit Plan, TRICARE, Veteran Administration, and active workers. Note: These estimates by type of prescription drug plan are not comparable to estimates of Medicare supplemental coverage by source of funding on the previous slide. (For example, employer-paid coverage could appear in several categories above.) “Creditable coverage” is defined as coverage that meets or exceeds the actuarial value of the standard Medicare Part D benefit.
  10. 10. Medicare Private Plan Enrollment (Medicare Advantage) Trends, Minnesota and U.S., 1997 to 2007 Source: Centers for Medicare and Medicaid Services, State County Plan Market Penetration File (1997 to 2005) and State/County/Contract Reports (2006 and 2007)
  11. 11. Minnesota Medicare Private Plan Enrollment in Urban and Rural Counties, 2004 & 2007 Source: Centers for Medicare and Medicaid Services, Monthly Enrollment from State/County/Contract Report, Dec. 2007; State County Plan Market Penetration File, 2004
  12. 12. Distribution of Minnesota Medicare Advantage Enrollees by Region and Type of Plan, 2007 CCP is Coordinated Care Plans; PFFS is Private Fee For Service Plans Source: CMS, Monthly Enrollment by State/County/Contract Report as of December 2007
  13. 13. Medical Assistance (MA) Minnesota’s Medicaid program – jointly financed by the state and the federal government – provides health insurance to low-income senior citizens, children and families, and people with disabilities.
  14. 14. Medical Assistance Enrollment and Spending History, 1999 to 2009 Source: Minnesota Department of Human Services, data for state fiscal years 7.7% 2.7% -4.6% $675 $2,997 370,054 1999 8.5% 7.9% -0.6% $733 $3,233 367,737 2000 7.5% 10.8% 3.0% $788 $3,582 378,884 2001 8.4% 15.5% 6.5% $854 $4,136 403,668 2002 4.5% 14.6% 9.6% $892 $4,740 442,585 2003 0.5% 5.3% 4.8% $897 $4,991 463,650 2004 0.5% 4.7% 4.1% $902 $5,224 482,861 2005 1.3% 4.6% 3.2% $913 $5,462 498,406 2006 4.6% 7.0% 2.4% $955 $5,846 510,155 2007 3.8% 7.2% 3.3% $991 $6,268 527,001 2008 Growth in: 2.2% 8.1% 5.8% $1,013 $6,775 557,337 2009 Spending per Enrollee Total Spending Enrollment Avg. Monthly Spending per Enrollee Spending ($ millions) Avg. Monthly Enrollment State FY
  15. 15. Medical Assistance Enrollment and Spending Growth, 1999 to 2009 Source: Minnesota Department of Human Services, data for state fiscal years
  16. 16. Medical Assistance Enrollees as Percent of Population, by Region, 2009 For the regional boundaries, see slide 39 at the end of this chartbook. Source: Minnesota Department of Human Services, enrollment data for fiscal year 2009; U.S. Census Bureau, population estimates of Minnesota counties for July 1, 2008 and the state for July 1, 2009
  17. 17. Statewide Distribution of Medical Assistance Enrollees, by Region, 2009 For the regional boundaries, see slide 39 at the end of this chartbook. Source: Minnesota Department of Human Services, enrollment data for fiscal year 2009
  18. 18. Medical Assistance Enrollment by Eligibility Category, 1999 and 2009 Source: Minnesota Department of Human Services
  19. 19. Medical Assistance Enrollment and Spending by Eligibility Category, 2009 Source: Minnesota Department of Human Services, data for state fiscal year 2009
  20. 20. MinnesotaCare A sliding-fee-scale Minnesota health insurance program - financed by state funds, federal funds, and enrollee premiums - for low income Minnesotans who are not offered insurance through their employer.
  21. 21. MinnesotaCare Enrollment and Spending History, 1999 to 2009 Source: Minnesota Department of Human Services, data for state fiscal years 39.3% 51.7% 8.9% $129 $164 106,552 1999 11.2% 13.8% 2.3% $143 $187 108,999 2000 14.4% 28.3% 12.2% $164 $240 122,247 2001 29.6% 46.3% 12.9% $212 $351 138,022 2002 13.0% 23.8% 9.6% $240 $435 151,206 2003 14.0% 11.9% -1.8% $273 $487 148,505 2004 -12.1% -16.0% -4.5% $240 $409 141,822 2005 18.0% 7.1% -9.2% $283 $438 128,727 2006 8.3% -0.8% -8.4% $307 $434 117,893 2007 9.9% 6.6% -3.0% $337 $463 114,350 2008 Growth in: 10.4% 13.7% 2.9% $372 $526 117,706 2009 Spending per Enrollee Total Spending Enrollment Avg. Monthly Spending per Enrollee Spending ($ millions) Avg. Monthly Enrollment State FY
  22. 22. MinnesotaCare Enrollment and Spending Growth, 1999 to 2009 Source: Minnesota Department of Human Services, data for state fiscal years
  23. 23. MinnesotaCare Enrollees as Percent of Population, by Region, 2009 For the regional boundaries, see slide 39 at the end of this chartbook. Source: Minnesota Department of Human Services, enrollment data for fiscal year 2009; U.S. Census Bureau, population estimates of Minnesota counties for July 1, 2008 and the state for July 1, 2009
  24. 24. Statewide Distribution of MinnesotaCare Enrollees, by Region, 2009 For the regional boundaries, see slide 39 at the end of this chartbook. Sources: Minnesota Department of Human Services, enrollment data for fiscal year 2009;
  25. 25. MinnesotaCare Enrollment by Eligibility Category, 1999 to 2009 Source: Minnesota Department of Human Services, data for state fiscal years *Average monthly enrollment based on different calculation than in slide 21. 13,904 59,941 32,707 106,552 1999 14,350 58,836 35,813 108,999 2000 18,573 63,862 39,812 122,247 2001 23,179 70,299 44,544 138,022 2002 30,831 73,046 47,329 151,206 2003 33,721 69,612 45,172 148,505 2004 32,651 65,949 43,222 141,822 2005 29,874 59,580 39,280 128,734 2006 34,018 50,918 32,957 117,893 2007 41,147 44,229 28,983 114,359 2008 Adults without Children Children Parents Avg. Monthly Enrollment State FY 47,655 41,680 28,366 117,701 2009*
  26. 26. MinnesotaCare Enrollment by Eligibility Category, 1999 and 2009 Source: Minnesota Department of Human Services
  27. 27. MinnesotaCare Funding Sources Source: Minnesota Department of Human Services
  28. 28. General Assistance Medical Care (GAMC) A state health insurance program for low-income adults, ages 21 to 64, who have no dependent children under 18 and who do not qualify for federal health care programs.
  29. 29. General Assistance Medical Care Enrollment and Spending History, 1999 to 2009 Source: Minnesota Department of Human Services, data for state fiscal years 9.6% -6.5% -14.7% $759 $263 28,853 2008 12.8% -2.7% -13.7% $692 $281 33,824 2007 -1.0% 9.6% 10.8% $751 $288 31,961 2009 14.6% 22.1% 6.5% $614 $289 39,199 2006 -8.5% -3.7% 5.3% $536 $237 36,797 2005 Growth in: 5.8% -1.0% -6.4% $586 $246 34,957 2004 8.9% 36.1% 24.9% $553 $248 37,340 2003 11.3% 35.3% 21.5% $508 $182 29,886 2002 0.1% 5.5% 5.3% $457 $135 24,592 2001 10.8% -3.4% -12.9% $456 $128 23,347 2000 27.2% 9.5% -13.9% $411 $132 26,794 1999 Spending per Enrollee Total Spending Enrollment Avg. Monthly Spending per Enrollee Spending ($ millions) Avg. Monthly Enrollment State FY
  30. 30. General Assistance Medical Care Enrollment and Spending Growth, 1999 to 2009 Source: Minnesota Department of Human Services, data for state fiscal years
  31. 31. General Assistance Medical Care Enrollees as Percent of Population, by Region, 2009 For the regional boundaries, see slide 39 at the end of this chartbook. Sources: Minnesota Department of Human Services, enrollment data for fiscal year 2009; U.S. Census Bureau, population estimates of Minnesota counties for July 1, 2008 and the state for July 1, 2009
  32. 32. Statewide Distribution of General Assistance Medical Care Enrollees, by Region, 2009 For the regional boundaries, see slide 39 at the end of this chartbook. Sources: Minnesota Department of Human Services, enrollment data for fiscal year 2009
  33. 33. Minnesota Comprehensive Health Association (MCHA) High-risk pool that offers health insurance to Minnesotans who have been turned down in the private market, due to preexisting conditions.
  34. 34. MCHA Enrollment and Spending History, 1998 to 2008 Claims per enrollee estimated by MDH using average of year-end enrollment figures. Source: Minnesota Comprehensive Health Association 4.8% 0.6% -6.1% $536 $206 31,049 2005 14.3% 7.2% -6.3% $613 $221 29,089 2006 5.5% 1.7% -0.8% $647 $225 28,859 2007 13.6% 17.1% -1.9% $512 $205 33,063 2004 11.9% 23.9% 8.4% $450 $175 33,705 2003 12.6% 9.3% -5.1% $728 $246 27,386 2008 Growth in: 3.3% 13.3% 13.3% $402 $141 31,088 2002 7.1% 11.3% 5.7% $389 $125 27,428 2001 8.2% 10.3% 2.0% $364 $112 25,938 2000 14.3% 12.3% 1.9% $336 $102 25,433 1999 4.6% -0.5% -5.2% $294 $91 24,954 1998 Claims per Enrollee Total Claims Enrollment Avg. Monthly Claims per Enrollee Claims ($ millions) Enrollment as of 12/31 Calendar Year
  35. 35. MCHA Enrollment and Spending Growth, 1998 to 2008 Claims per enrollee estimated by MDH using average of year-end enrollment figures. Source: Minnesota Comprehensive Health Association
  36. 36. MCHA Claims, Premiums, and Losses from Operations, 1998 to 2008 Source: Minnesota Comprehensive Health Association (MCHA) 50.7% $120 $114 $225 2007 50.6% $118 $112 $221 2006 54.9% $103 $113 $206 2005 52.3% $110 $107 $205 2004 47.3% $139 $116 $246 2008 53.4% $90 $93 $175 2003 54.7% $72 $77 $141 2002 52.2% $67 $65 $125 2001 52.4% $59 $59 $112 2000 51.1% $57 $52 $102 1999 52.8% $47 $48 $91 1998 Premiums as % of Claims Losses from Operations ($ millions) Premiums ($ millions) Claims ($ millions) Calendar Year
  37. 37. MCHA Enrollees as Percent of Population, by Region, 2008 Source: Minnesota Comprehensive Health Association (MCHA)
  38. 38. Statewide Distribution of MCHA Enrollees, 2008 Includes only enrollees currently residing in Minnesota. Sources: Minnesota Comprehensive Health Association (MCHA)
  39. 39. Age Distribution of MCHA Enrollees, 2008 Source: Minnesota Comprehensive Health Association (MCHA)
  40. 40. Minnesota Counties and Regions Used in the Geographic Analysis

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