Modifiable.coverage.gap.presentation

Georgia’s Coverage Gap

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Organization

Introduction slide

• Organization name and logo. • Other important org. info. • Member of Cover Georgia coalition

Pathways to Coverage under the ACA

Employer-based coverage

Individual/non-group (healthcare.gov)

(Coverage Gap)

Public health insurance coverage

Medicare

Medicaid

TriCare (Veterans)

Kids: PeachCare/Medicaid

People who qualify for Medicaid:•Children (up to age 19)•Women who: •Are pregnant•Have breast, cervical

cancer•Low to mid-income

•Aged, blind, disabled (very low income)•Very low-income parents

(Ex: must earn less than $5500/year for family of three)•People in long-term care

(nursing homes)

Georgia’s coverage gap

An example

FYIFederal Poverty Line (FPL)—a measure of income set by US Dept. of Health & Human Services. Used to determine a person’s eligibility for certain programs and benefits

Family Size

Annual Income

1 $11,770

2 $15,930

3 $20,090

4 $24,250

100% Federal Poverty Line 2015

Low-wage workers Construction workers, restaurant servers, retail

workers, child care providers

Parents Working parents who make 39% FPL and 100% FPL

Non-working parents who make 30% FPL to 100% FPL

Veterans 20,000 Georgia veterans + 4000 spouses

Childless adults who earn less than 100% FPLSource: http://www.urban.org/uploadedpdf/412775-Uninsured-Veterans-and-Family-Members.pdf

An opportunity for Georgia

The economics of closing the coverage gap

• Georgia can easily cover its share of the costs• State savings & new revenue will offset new spending• “Use it or lose it”• Georgia can opt out at any time

Total 4 year costs $575 millionTotal 4 year revenue $700 million

SourceCost estimates: Tim Sweeney, Georgia Budget & Policy Institute

Other states have closed their gaps

Expansion• Uninsured rates down 37.7% 1

• Hospitals saved $4.2 billion (2014)2

• Improved health outcomes, especially among older adults, racial/ethnic minorities, and residents of poorer counties3

• State budget savings

Non-expansion• Uninsured rates dropped only

9% 1

• Hospitals saved $1.5 billion (2014) 2

• No state budget savings

Other states have closed their gaps

Sources: 1. http://hrms.urban.org/briefs/taking-stock-at-mid-year.html 2. Dept. of HHS, http://www.hhs.gov/news/press/2014pres/09/20140924a.html 3. New England Journal of Medicinehttp://www.nejm.org/doi/full/10.1056/NEJMsa1202099#t=articleResults

State budget savings & revenue gains

AR$153 M

KY$109 M

MI$468 M

CO$307 M

WA$464 M

OR$275 M

Source: Manatt Health Solutions, States Expanding Medicaid See Significant Budget Savings and Revenue Gains

Key sources of savings

When Georgia closes its coverage gap…

People• Affordable health care access for 300,000

Georgians• Financial, health peace of mind

Economy• $8 billion per year in new economic

activity• $220 million per year in new tax revenue

Health Care Industry

• $3 billion in federal money annually

• Reduce uncompensated care costs for all hospitals

• Help to stabilize failing rural hospitals

Workforce

• 56,000 new jobs created Source: Dr. William Custer, Economic Impact of Medicaid Expansion in Georgia

What can you do?

Now! Sign a postcard to your legislators

• Online at: surveymonkey.com/s/closethecoveragegap Share your coverage gap story

• Include email address here about where to send coverage gap stories. Can use [email protected] if you’d like.

Add your organization’s name to our list of supporters

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