Briefing onAlabama Medicaid

R. Bob Mullins, Jr. MD

Commissioner

Alabama Medicaid Agency

November 20111

Today’s Top Issues

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The number of AL citizens on Medicaid is growing. Average monthly enrollment increased 33 percent between 2001 and 2010.

Medicaid will consume about 35 percent of the FY 2012 General Fund budget. If current trends continue, Medicaid would require 92 percent of the General Fund in FY 2020.

Medicaid plays an essential role in the state’s economy by funding jobs, generating income and state tax revenues and by providing health care services for all citizens.

Economic Impact of Alabama Medicaid

Direct Impact 96,235 Jobs Directly Supported $203,975,720 State Sales Tax $214,174,506 State Income Tax

Secondary Impact 47,155 Jobs $3,161,623,660 in Additional Supported Income $83,630,046 State Sales Tax $87,811,548 State Income Tax

(Due to employee and business spending) 3

Economic Impact of Alabama Medicaid

Total Impact on Jobs,

Income & Selected Taxes 143,390 Jobs $3,161,623,660 in Additional Income $589,591,820 in Select Taxes

Total Monetary Impact in Alabama:

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Today’s Top Issues

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Updated technology is essential: To manage expanded enrollment if health care

reform is implemented To develop the infrastructure for the exchange

electronic health record information To build the infrastructure to support the state

health insurance exchange More primary health care providers are needed

1,000 more needed if health care reform is implemented

Health Benefits / Information Exchanges

Alabama is one of 10 states chosen by Robert Wood Johnson Foundation for expert technical assistance to develop Benefits Exchange and related projects, including Level 1 Funding application for federal funds

Medicaid developing Customer Service Centers throughout state that will ultimately serve as enrollment centers for the Benefits Exchange

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Medicaid RecipientsFY 2010

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Impact on Alabama Citizens

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21.1 percent of state’s population qualified for some type of Medicaid at least one month during FY 2011 – that number is growing

More than one-half of all babies born in AL (30,000+) covered

Two-thirds of all nursing home residents are covered by Medicaid

43.5 percent of all Alabama children are eligible 43 percent of children on Medicaid have at

least one working parent

Average Monthly Enrollment

FY 2001 – 639,615

FY 2008 – 756,564

FY 2009 – 759,990

FY 2010 – 851,199

FY 2001 to FY 2010 – Up 211,584 (33.1%)*Medicaid Report ELIGPROJ Diff 6-16-11

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Average Monthly Enrollment

FY 2011 (Projected) – 909,821

FY 2012 – (Projected) – 953,961

FY 2013 – (Projected) – 997,752

FY 2014 – (Projected) – 1,124,347*

Based on Medicaid Report ELIGPROJ Diff 7-15-11

*Projected impact of Health Care Reform / Medicaid Expansion

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Who Qualifies for Medicaid:

Alabama’s income limits among the most restrictive in the country

Low-income families (Family of 4 must have < $194/mo. income)Children ages 6-19 (100% FPL) Pregnant women / children ages 0-5 (133% FPL)SSI for Aged, Blind and Disabled (certified by SSA) Medicare-related programs (QMB, SLMB, QI-1) Nursing Home MedicaidHome and Community-Based Waivers

Same limits as nursing home 11

Who Qualifies for Medicaid:

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Medicaid Payment Rates 1997-2016

Medicaid’s Funding

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Medicaid will consume about one third of the FY12 General Fund Budget

If current trends continue, Medicaid would require about 92 percent of the General Fund Budget by FY 2020

Medicaid is looking for ways to reduce costs while improving the cost of care.

Key projects to this effort include: Patient Care Networks (3 pilots underway now) PACE programs / Long Term Care in the Community Pharmacy Initiatives