HEALTH CARE ACCESS RECOMMENDATIONS: Medicaid

1
HEALTH CARE ACCESS RECOMMENDATIONS Medicaid

• Presentation to
• Governor Kaines Health Reform Commission
• Health Care Access Workgroup

April 25, 2007
Department of Medical Assistance Services
2
Initial Medicaid/FAMIS Coverage Options

• M1 Expand Coverage of Children Ages 0-18
• M2 Expand Coverage of Parents Ages 19-64
• M3 Expand Coverage of Aged, Blind and Disabled
  Individuals
• M4 Expand Coverage of Pregnant Women over age
  19
• M5 Expand Coverage to Childless Adults ages
  19-64

3
Revised Medicaid/FAMIS Coverage Options

• M1 Expand Coverage of Children Ages 0-18
• 250 FPL
• 300 FPL
• M2 Expand Coverage of Parents Ages 19-64
• 65 FPL (with or without dental)
• 100 FPL (with or without dental)
• M4 Expand Coverage of Pregnant Women over age
  19
• 200 FPL (with or without dental)

4
2007 Federal Poverty Level (FPL) Guidelines
Source 2007 Federal Poverty Guidelines, U.S.
Dept. of Health and Human Services
5
Medicaid Options Coverage, Cost, and Ranking
Amounts are in millions and reflect FY 2008
costs future amounts would be subject to
inflation utilization changes
6
Medicaid Options Coverage, Cost, and Ranking
Amounts are in millions and reflect FY 2008
costs future amounts would be subject to
inflation utilization changes Includes cost
to provide dental to existing parents ages 19-64
7
Medicaid Options Coverage, Cost, and Ranking
Amounts are in millions and reflect FY 2008
costs future amounts would be subject to
inflation utilization changes Includes cost
to provide dental to existing parents ages 19-64
8
Medicaid Options Coverage, Cost, and Ranking
Amounts are in millions and reflect FY 2008
costs future amounts would be subject to
inflation utilization changes
9
Medicaid Options Coverage, Cost, and Ranking
Amounts are in millions and reflect FY 2008
costs future amounts would be subject to
inflation utilization changes
10
Recap of Medicaid Options in Rank Order

• 1. Expand coverage for Parents to 100 FPL
  w/dental (7 votes)
• 2. Expand coverage for Parents to 65 FPL
  w/dental (5 votes)
• 3. Add dental services to existing coverage for
  Parents (3 votes)
• 4. Expand coverage for Children to 300 FPL (2
  votes)
• 5. Expand coverage for Children to 250 FPL (1
  vote)
• 5. Expand coverage for Parents to 100 FPL (no
  dental) (1 vote)
• 5. Expand coverage for Pregnant Women to 200
  FPL (1 vote)
• 8. Expand coverage for Parents to 65 FPL (no
  dental) (no votes)

3 Options Tied for 5th place
11
Medicaid Coverage for Certain Legal Permanent
Residents (LPRs)

• It is estimated that there will be a total of
  44,892 LPRs in Virginia in FY 2008
• Of this total, it is estimated that there are
  1,732 uninsured LPR caretaker adults below 100
  FPL.
• Estimated annual cost to cover these LPRs
• 3.1 million GF (w/o dental)
• 3.4 million GF (w/dental)
• NOTE estimates are very preliminary due to
  limited data
• There were 2 votes for this option

12
PRELIMINARY WORKGROUP RECOMMENDATIONS Medicaid

• Recommendation 1
• Increase Medicaid eligibility for parents to 100
  FPL with dental, and
• Add dental services for existing Medicaid-covered
  parents
• 121.6 million annual GF cost, 64,691 enrollees
• Recommendation 2
• Increase Medicaid coverage for legal immigrant
  (LPR) caretaker adults
• 3.4 million annual GF cost, 1,732 enrollees