medicaid and the uninsured

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Monica Bradford
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1 kaiser commission on K E Y F A C T S medicaid and the uninsured Most Affected by Hurricane Katrina Demographic Profile, unless otherwise indicated Total Population in Thousands (2004) 4,516 2,903 22,490 4, ,655 Percent of U.S. Total 2% 1% 8% 2% -- Percent Children Under Age 19 28% 29% 30% 27% 27% Percent Adults Age 65 and Older 12% 11% 10% 13% 12% Total Percent Living in Poverty 22% 23% 22% 20% 17% Rank (1 is highest % in poverty) Percent of Children Living in Poverty 31% 31% 29% 26% 23% Median Annual Household Income $35,523 $33,659 $41,275 $38,111 $44,473 Gross State Product (in billions), 2003 $140 $72 $813 $132 $10,911 Percent of U.S. Total 1.3% 0.7% 7.5% 1.2% -- Unemployment Rate (July 2005) 5.6% 6.5% 5.0% 4.0% 5.0% Race and Ethnicity White 63% 60% 47% 69% 68% African American 32% 37% 11% 26% 12% Hispanic 3% 1% 38% 1% 14% Other 2% 2% 5% 4% 6% Health Coverage of the Non-Elderly, All Incomes Uninsured 22% 19% 28% 15% 18% Rank (1 is highest % uninsured) Medicaid 19% 23% 14% 16% 15% Rank (1 is highest % in Medicaid) Private Insurance 59% 58% 58% 69% 67% Low-Income (<200% FPL) Uninsured 36% 29% 45% 30% 33% Medicaid 35% 43% 27% 35% 34% Private Insurance 29% 28% 28% 35% 33% Health Status Indicators Infant Mortality (per 1,000 births), Percent of Children Immunized ( ) 68% 78% 72% 79% 78% Smoking Rate, % 27% 23% 24% 23% Prevalence of Adult Diabetes, % 11% 8% 9% 7% Obesity Rate, % 26% 24% 23% 21% Heart Disease Mortality (per 100,000), Cancer Mortality (per 100,000), AIDS Case Rate (per 100,000, 2003) G S T R E E T NW, W A S H I N G T O N, DC P H O N E: , F A X: , P U B L I C A T I O N S: W W W. K F F. O R G

2 Key Facts - Most Affected by Hurricane Katrina Medicaid Enrollment Total Enrollment (in 1,000s), , , ,400 Percent Distribution by Group, 2001 Children 58% 55% 57% 49% 50% Adults 12% 11% 17% 16% 24% People with Disabilities 20% 21% 13% 21% 15% Elderly 11% 14% 13% 14% 11% SCHIP Enrollment (in 1,000s), 12/ ,950 Medicaid Expenditures Total Spending in billions (2003) $4.6 $2.9 $15.3 $3.5 $266.8 Acute Care 55.2% 64.2% 60.5% 56.2% 58.3% Long-Term Care 26.7% 30.1% 30.9% 33.7% 36.4% Disproportionate Share Hospital (DSH) 18.0% 5.7% 8.6% 10.1% 5.3% 2005 FMAP 71.04% 77.08% 60.87% 71.00% FMAP 69.79% 76.00% 60.66% 69.51% -- Distribution of Medicaid Expenditures on Services, 2001 Percent Distribution by Group Children 15% 17% 22% 18% 16% Adults 8% 9% 11% 5% 11% People with Disabilities 47% 42% 37% 26% 40% Elderly 26% 32% 28% 29% 29% Unknown 4% 1% 2% 22% 5% Total Per Enrollee Spending (without DSH) $3,251 $3,202 $3,534 $3,780 $4,011 Children $855 $1,006 $1,362 $1,389 $1,315 Adults $2,280 $2,501 $2,265 $1,048 $1,736 People with Disabilities $7,828 $6,512 $9,900 $4,843 $10,642 Elderly $7,433 $7,401 $7,609 $7,664 $10,619 Medicaid and Medicare Dual Eligibles, 2003 Full Dual Eligible Enrollment (1,000s) ,200 Dual Eligibles as % of Total Medicaid 14% 19% 16% 21% 14% Medicaid Dual Eligible Spending (in millions) $1,456 $1,331 $5,265 $1,550 $105,405 as % of Total Medicaid 36% 44% 39% 39% 40% Dual Eligible Spending on Drugs (in millions) $267 $326 $734 $211 $15,172 Notes and Sources Notes: The Federal Poverty Level (FPL) is roughly $16,000 per year or $1,340 per month for a family of three in FMAP refers to the Federal Medical Assistance Percentage, which is the federal share of program spending. Demographic Profile and Health Insurance Coverage : KCMU and Urban Institute analysis of the Current Population Survey, March 2003 and All other data from Kaiser statehealthfacts.org Medicaid: KCMU and Urban Institute Analysis of HCFA-64 and MSIS data; National Association of State Budget Officers. KCMU and Health Management Associates analysis of SCHIP enrollment data; CMS; Center on Budget and Policy Priorities. 2

3 Key Facts - Most Affected by Hurricane Katrina Medicaid Eligibility Levels, 2004 Children Federal Minimums % FPL 185% FPL 185% FPL 133% FPL 133% FPL % FPL 133% FPL 133% FPL 133% FPL 133% FPL % FPL 100% FPL 100% FPL 100% FPL 100% FPL Separate State SCHIP Program % FPL 200% FPL 200% FPL -- Pregnant Women 200% FPL 185% FPL 185% FPL 175% FPL 133% FPL Parents U.S. Median Non-Working 13% FPL 28% FPL 14% FPL 13% FPL 42% FPL Working 20% FPL 35% FPL 33% FPL 19% FPL 69% FPL Medicaid Enrollment Procedures, 2004 Children Waiting Period None None 90 days post 3 months eligibility Face-to-Face Interview Required Medicaid No Yes No Yes Separate SCHIP -- Yes No No Asset Test Required Medicaid No No Yes ($2k) No Separate SCHIP -- No Yes ($5k) No Presumptive Eligibility No No No No 12-Month Continuous Eligibility Medicaid Yes Yes No Yes Separate SCHIP -- Yes No Yes Parents Family Application No Yes No Yes Face-to-Face Interview Required No Yes Yes Yes Asset Test Required No No Yes No Renewal Frequency 12 months 12 months 6 months 12 months Pregnant Women Asset Test Required No No No No Presumptive Eligibility Yes No Yes No Self-Declaration Permitted for Children, 2004 Income Medicaid for Children No No No No Separate SCHIP -- No No Yes Residency Medicaid for Children Yes Yes Yes Yes Separate SCHIP -- Yes Yes Yes Age Medicaid for Children Yes No Yes Yes Separate SCHIP -- No Yes Yes 3

4 Key Facts - The City of New Orleans United Demographic Profile, 2004 Total Population 444, million Percent Living in Poverty 23% 13% Children Under Age 18 15% 14% Adults age 65 and Older 11% 12% Race and Ethnicity White 28% 75% African American 68% 12% Hispanic (any race) 3% 14% Other 4% 12% Median Income $31,369 $44,684 Housing Statistics, 2004 Total Occupied Housing Units 180, million Housing Units with No Cars 38, million Percent with no Cars 21% 9% Health Status Indicators Disability Status 16% 14% Source U.S. Census Bureau, 2004 American Community Survey 4

5 Louisiana Medicaid Enrollment by Parish (County) As of 8/29/2005 Enrollment by Eligibility Group Total Aged Blind Disabled Children Parents Buy In State Total 996,894 59,156 1, , ,023 90,505 58,102 Severely Impacted Parishes (Highlighted and Bold) 353,875 17, , ,152 34,571 19,962 % of Total 35% 30% 25% 38% 35% 38% 34% Total Impacted Parishes, Including FEMA (Bold Only) 653,175 33,056 1,037 99, ,279 61,973 37,233 % of Total 66% 56% 56% 65% 66% 68% 64% Parish (County) Acadia 15,764 1, ,322 9,760 1,356 1,103 Allen 6, , Ascension 13, ,637 9,330 1, Assumption 5, , Avoyelles 12,675 1, ,160 7, ,030 Beauregard 6, , Bienville 4, , Bossier 16, ,243 10,898 1, Caddo 57,777 3, ,333 36,527 5,229 2,757 Calcasieu 37,211 1, ,028 25,783 2,597 1,909 Caldwell 2, , Cameron 1, Catahoula 2, , Claiborne 4, , Concordia 5, , DeSoto 5, , East Baton Rouge 80,711 3, ,094 53,284 8,762 3,671 East Carroll 3, , East Feliciana 4, , Evangeline 11,404 1, ,052 6,414 1, Franklin 6, , Grant 4, , Iberia 18,990 1, ,680 12,219 1,841 1,158 Iberville 8, ,298 5, Jackson 3, , Jeff Davis 7, , Jefferson--East Bank 31,353 1, ,181 20,400 2,909 2,162 Jefferson-West Bank 51,748 2, ,870 32,900 5,428 2,264 Lafayette 33,745 1, ,551 22,033 3,234 1,934 Lafourche 18, ,764 11,729 1,656 1,335 LaSalle 2, , Lincoln 8, ,108 5, Livingston 18, ,951 13,119 1,502 1,202 Madison 4, , Morehouse 9, ,382 5, Natchitoches 9, ,478 5, Orleans 134,249 6, ,038 81,898 14,047 7,178 Ouachita 34,559 1, ,713 22,778 3,441 1,682 Plaquemines 5, , Pointe Coupee 5, , Rapides 32,556 2, ,837 19,530 2,406 1,602 Red River 2, , Richland 6, , Sabine 4, , St. Bernard 12, ,911 7,573 1, St. Charles 8, ,041 5, St. Helena 2, , St. James 4, , St. John 10, ,479 7,059 1, St. Landry 26,207 2, ,559 15,481 2,085 1,635 St. Martin 11, ,408 7, St. Mary 14, ,194 9,704 1, St. Tammany 28,894 1, ,744 19,997 2,481 1,352 Tangipahoa 29,280 1, ,157 18,132 2,544 1,699 Tensas 2, , Terrebonne 23, ,235 14,862 1,975 1,608 Union 4, , Vermilion 11, ,428 7, Vernon 7, , Washington 13, ,586 7, ,097 Webster 9, ,574 5, West Baton Rouge 4, , West Carroll 3, , West Feliciana 1, , Winn 3, , Source: Louisiana Bureau of Health Services Financing,

TITLES I, II, and III

TITLES I, II, and III Chapter: 15 Chapter Title: Assignment of Cases and Preliminary Motions Appendix 15.1 Rule No: 15.1 Alternative Method of Service on District Attorney 1st Judicial District Caddo In