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United Way of Southeast Louisiana Public Policy Committee

Educational Session: Medicaid Maximization

October 8, 2013

Dr. Karen DeSalvo, Health Commissioner, City of New Orleans

Why Health Coverage Matters

Profile of the Uninsured780,000 people in LA – the typical uninsured person is: Ages 18-64 Male White, non-Hispanic Native born High school graduate Employed Living below 138% of federal

poverty line (FPL) Food service, construction,

retail, health care, child care, school, and hotel workers.

679 people die in Louisiana annually as a result of being uninsured

The cost of caring for

the uninsured amounts to a $1,000/year “hidden” tax on those with private insurance

The Affordable Care Act:3 Key Provisions

1. Insurance reforms: guaranteed issue, modified community rating, no pre-existing condition exclusions

2. Coverage expansion – through Medicaid, up to 138% FPL

3. Coverage expansion – through Private Health Insurance on the Marketplace

ACA is financed through: Medicare payment cuts and savings Disproportionate Share Hospital payment cuts New taxes

2005

• Hurricane Katrina and Levee Failures2006

• Louisiana Healthcare Redesign Collaborative 2007

• Coalition of Leaders in Louisiana Healthcare2007

• Primary Care Access to Stabilization Grant 2008

• Louisiana Health First 2010

• Greater New Orleans Community Health Connection

2013

• GNOCHC Extension

History of Health Reformin Louisiana is Bipartisan

Community Health Centers

2005

• Hurricane Katrina and Levee Failures2006

• Louisiana Healthcare Redesign Collaborative 2007

• Coalition of Leaders in Louisiana Healthcare2007

• Primary Care Access to Stabilization Grant 2008

• Louisiana Health First 2010

• Greater New Orleans Community Health Connection

2013

• GNOCHC Extension

History of Health Reformin Louisiana is Bipartisan

291,000 uninsured adults in Louisiana below 138% FPL would gain comprehensive insurance (DHH and Legislative Fiscal Office - LFO)

Expected to bring nearly $16 billion in federal health care investment to the state over 10 years (KFF)

Would increase economic activity in Louisiana an additional $1.8 billion in 2016 alone (Families USA, 2013)

The federal government would cover 100% of cost for first 3 years and 94% of all costs

Medicaid Maximization Impact

Louisiana Legislative Fiscal Office, Fiscal Note

Scenario Take-Up Rate SGF Savings, 10 yrs

Low Impact 75% $510 million

High Impact 95% $185 million

The Affordable Care Act:3 Key Provisions

1. Insurance reforms: guaranteed issue, modified community rating, no pre-existing condition exclusions

2. Coverage expansion – through Medicaid, up to 138% FPL

3. Coverage expansion – through Private Health Insurance on the Marketplace

ACA is financed through: Medicare payment cuts Disproportionate Share Hospital payment cuts

Calculating Premium Assistance: $9.00/hr part-time

worker

kff.org/interactive/subsidy-calculator

KFF Premium Subsidy Calculator

Thank you.

www.nola.gov/healthkdesalvo@nola.gov