- Medicare is a social insurance program that provides health coverage to individuals aged 65 and older as well as those who are permanently disabled, regardless of income or health status. It covers over 43 million Americans. - Medicare spending is projected to increase substantially by 2030 as the number of people enrolled is expected to rise from 46 million to 78 million. However, the program is facing financial challenges as costs are expected to exceed funding levels by 2019. - Medicaid provides health coverage to over 74 million low-income individuals, including children, pregnant women, elderly, and disabled. Each state administers its own Medicaid program within federal guidelines.

1. Health Care Reform January 12, 2009

2. Medi NEGLECT

3. Health Insurance Coverage in the U.S. in 2006

4. Medicare is a social insurance program that provides health coverage to individuals, without regard to their income or health status 16% are under 65 and permanently disabled What is Medicare?

5. Fee-for-service (FFS) or private health plans (HMOs, PPOs) Advantage plans generally provide all benefits covered under traditional Medicare, but many plans offer additional benefits How are benefits provided?

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8. 10.1 million beneficiaries are now enrolled in a Medicare Advantage plan, up from 5.3 million in 2003 Government pays 113% more for beneficiaries enrolled in Medicare Advantage than for beneficiaries in traditional Medicare in 2008 Quick Facts on Medicare

9. By 2019, there will be insufficient funds in the Medicare Part A (Hospital Insurance) Trust Fund to pay for benefits Current benefit levels cannot be sustained without additional revenue Financing Care for Future Generations

10. Medicare Revenue and Spending

11. Medicare is 14% of the federal budget From 2010 – 2030, the number of people on Medicare is projected to rise from 46 million to 78 million Medicare covers less than half of beneficiaries’ total medical and long-term care expenses Quick Facts on Medicare

12. Medicare is listed as a “high-risk” government program Fewer than 5% of Medicare claims are audited Medicare fraud costs taxpayers over $60 billion a year Medicare Fraud

13. Medicaid is a joint program with costs shared by federal & state government Largest children’s health program Each state establishes its own standards for Medicaid eligibility, benefits package, & provider payment rates What is Medicaid?

14. Medicare is a federal program that covers 43 million senior citizens and retirees over 65 Medicaid is a program designed to provide health coverage for children Medicaid and Medicare share other costs associated with “dual eligibles”- people who qualify for both programs Is Medicaid the same as Medicare?

15. 3 in every 10 American children are enrolled in Medicaid Over ½ of Medicaid enrollees are children Medicaid serves over 24 million Each state establishes its own standards for Medicaid eligibility Quick Facts on Medicaid

16. So what do Medicare and Medicaid cost?

17. $320 billion Cost of Medicare and Medicaid Medicaid Medicare + $440 billion $760 billion

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20. 47 Million Americans 1.3 million full-time workers lost coverage in 2006 37.7 million workers uninsured in 2006 because their businesses did not provide quality coverage Who are the uninsured?

21. Uninsured are paying “up front” 20% of uninsured say their usual source of care is the emergency room Deaths among uninsured adults 25-64 is 18,000 a year How does being uninsured harm individuals and families?

22. US spends $100 billion per year to provide uninsured residents with health services Hospitals provide $34 billion worth of uncompensated care a year An additional $37 billion is paid by private and public payers for health services for the uninsured and $26 billion is paid out-of-pocket by those who lack coverage How it Affects You

23. The US has spent $656.1 billion on the war in Iraq to date With the money spent on the Iraq war, the US could insure 193,370,980 people with health care for one year How it Affects You (con’t)

24. So how can we fix the Health Care Crisis?