Figure 0
Maintaining Medicaid & CHIP in an
Economic Downturn
Diane Rowland, Sc.D.
Executive Vice President,
Henry J. Kaiser Family Foundation
and
Executive Director,
Kaiser Commission on Medicaid and the Uninsured
for
AcademyHealth Annual Research Meeting
Chicago, IL
June 29, 2009
K A I S E R
C O M M I S S I O N
O N
Medicaid and the Uninsured
Figure 1
Medicaid Today
Health Insurance
Coverage
Assistance to
Medicare Beneficiaries
Long-Term Care
Assistance
29.5 million children & 15
million adults in low-income
families; 14 million elderly and
persons with disabilities
8.8 million aged and disabled
— 19% of Medicare
beneficiaries
1 million nursing home
residents; 2.8 million
community-based residents
MEDICAID
Support for Health Care
System and Safety-net
State Capacity for Health
Coverage
16% of national health spending;
40% of long-term care services
Federal share ranges 50% to 76%;
44% of all federal funds to states
K A I S E R
C O M M I S S I O N
O N
Medicaid and the Uninsured
Figure 2
Health Insurance Coverage
of the Nonelderly by Poverty Level, 2007
100%
35%
29%
18%
5%
10%
4%
7%
11%
75%
Uninsured
27%
50%
45%
71%
25%
83%
92%
44%
Medicaid/
Other Public
Employer/
Other Private
20%
0%
<100% FPL 100-199%
FPL
200-299%
FPL
300-399% 400%+ FPL
FPL
The federal poverty level (FPL) was $21,203 for a family of four in 2007. Data may not total 100% due to rounding.
SOURCE: KCMU/Urban Institute analysis of March 2008 CPS.
K A I S E R C O M M I S S I O N
O N
Medicaid and the Uninsured
Figure 3
National Unemployment Rate
(January ’08 – May ’09)
9.4%
8.9%
8.5%
8.1%
7.6%
7.2%
6.6% 6.8%
6.2% 6.2%
5.5% 5.6%
5.8%
4.9% 4.8% 5.1% 5.0%
Jan
'08
Feb
'08
Number of
Unemployed 7,555 7,423
(in thousands)
Mar
'08
Apr
'08
7,820
7,675
May
'08
8,536
Jun
'08
8,662
Jul
'08
Aug
'08
8,910 9,550
Sept
'08
9,592
Oct
'08
Nov
'08
Dec
'08
Jan
'09
Feb
'09
Mar
'09
Apr
'09
May
'08
10,221 10,476 11,108 11,616 12,467 13,161 13,724 14,511
SOURCE: Bureau of Labor Statistics, Labor Force Statistics from the Current
Population Survey: Unemployment Level and Rate. June 2009.
K A I S E R
C O M M I S S I O N
O N
Medicaid and the Uninsured
Figure 4
States with Unemployment Rates at Various Levels,
May 2009
VT
NH
ME
WA
ND
MT
MA
MN
SD
OR
NY
WI
MI
CT
ID
PA
IA
WY
NE
IL
NV
UT
CA
KS
MO
IL
WV
CO
DE
VA
MD
KY
NC
DC
TN
AZ
OK
NM
SC
AR
MS
TX
NJ
OH
IN
RI
AL
GA
LA
AK
FL
HI
4.0% - 6.9% ( 11 states)
US Average: 9.4% in May 2009
7.0% - 8.9% (21 states)
9.0% - 14.1% (19 states including DC)
Note: May 2009 state figures are preliminary.
SOURCE: State and territory figures from the Table 3, Regional and State
Employment and Unemployment: May 2009, Bureau of Labor Statistics.
K A I S E R
C O M M I S S I O N
O N
Medicaid and the Uninsured
Figure 5
Impact of the Rise in Unemployment on Health
Coverage, 2007 to 2009
4.9
4.5
4.5%
=
National
Unemployment
Rate Increase
since 2007
(from 4.9% in Dec-07
to 9.4% in May-09)
Decrease in
Employer
Sponsored
Insurance
(million)
11.1
&
Medicaid
/CHIP
Enrollment
Increase
Uninsured
Increase
(million)
(million)
Note: Totals may not sum due to rounding and other coverage.
K A I S E R C O M M I S S I O N O N
Source: John Holahan and Bowen Garrett, Rising Unemployment, Medicaid, and the
Medicaid and the Uninsured
Uninsured, prepared for the Kaiser Commission on Medicaid and the Uninsured, January 2009.