Medicaids Role for Women Alina Salganicoff, Ph.D. Vice President - - PowerPoint PPT Presentation

Medicaid’s Role for Women

Alina Salganicoff, Ph.D. Vice President and Director, Women’s Health Policy Kaiser Family Foundation Medicaid and Women: Looking to the Future May 11, 2006 Barbara Jordan Conference Center Washington, DC

Medicaid is a critical health care safety net for millions of low-income women

112.3 Million

Note: Includes women ages 18 and older. Low-income defined as family incomes less than 200% of the federal poverty level ($31,340 for a family of three in 2004.) Source: Kaiser Family Foundation analysis of Urban Institute estimates based on March 2005 Current Population Survey, Census Bureau.

Employer- based / Other 58% Medicare 17% Uninsured 15% Medicaid and Medicare 3% Medicaid 7% Employer- based / Other 28% Uninsured 28% Medicare 23% Medicaid and Medicare 6% Medicaid 15%

41.3 Million

Low-Income Women All Women Figure 1

Women’s health insurance coverage, 2004

Women comprise the majority of adults on Medicaid

70% 73% 58% 67% 80% 20% 33% 30% 27% 42% Total 19 to 44 45 to 64 65 to 84 85 and

• lder

Men Women

Source: Kaiser Commission on Medicaid and the Uninsured Analysis of 2003 MSIS data, 2006.

Figure 2

Distribution of adult Medicaid enrollment, by sex and age, 2003

Most women on Medicaid are in their reproductive years

65+ 22% 45 to 64 16% 19 to 44 62%

Source: Kaiser Commission on Medicaid and the Uninsured, Analysis of 2003 MSIS Data, 2006.

Distribution of women ages 19 and older on Medicaid, 2003 Figure 3 Total = 19 million women

Medicaid finances key services for women across the lifespan

• Reproductive Years

– Family planning & STD testing and treatment – Maternity care - prenatal and delivery; pays for 37% of U.S. births – Abortion very limited – Mental health

• Mid-life

– Disability - ICF/MR, rehabilitation, therapy, transportation – Chronic illness treatment and screenings – Breast and cervical cancer treatment option

• Seniors

– Nursing home stays – Home and community services - personal care, case management – Vision, dental, rehabilitation

Figure 4

Women on Medicaid are diverse

28% 49% 68% 28% 24% 32% 27% 21% 6% 18%

Poverty Status Race/Ethnicity Family Composition

African- American

Other*

Note: Includes women on Medicaid ages 18 to 64. *Other consists of 4% Asian/Pacific Islander, 1% American Indian/Aleutian Eskimo, 1% multi-racial. The federal poverty level was $15,670 for a family of three in 2004. Source: Kaiser Family Foundation analysis of Urban Institute estimates based on March 2005 Current Population Survey, Census Bureau. White Hispanic <50% FPL 50 to 99% FPL 100 to 199% FPL >200% FPL No children under 18 in household Children under 18 in household

Figure 5

Characteristics of non-elderly women on Medicaid, 2004:

Women on Medicaid have considerable health needs

30% 16% 8% 16% 21% 20% 11% 6% 16% 12% 40% 28% 13% 28% 34% Medicaid Private Uninsured

Note: Among women ages 18 to 64. *Significantly different from private, p<.05. Source: Henry J. Kaiser Family Foundation, Kaiser Women’s Health Survey, 2004.

Percentage of non-elderly women reporting they have been diagnosed with condition in past five years:

Figure 6

Fair/Poor Health Arthritis Diabetes Asthma/Other Respiratory Conditions Anxiety/Depression

Medicaid improves access to care for women

40% 48% 30% 33% 20% 18% 7% 12% 16% 27% 11% 10%

No Pap test in past two years No breast exam in past two years No usual source of care No MD visit in past year

Medicaid Private Uninsured

Note: Includes women ages 18 to 64. Source: Kaiser Family Foundation, 2004 Kaiser Women’s Health Survey.

Figure 7 Use of health care services, by type of insurance, 2004

23% 28% 13% 11% 18% 33% Medicaid Private Uninsured

Note: Includes women ages 18 to 64. *Significantly different from Private, p<.05. Source: Kaiser Family Foundation, 2004 Kaiser Women’s Health Survey.

* *

Access to physician care can be challenging for women on Medicaid

Percentage of non-elderly women reporting that in the past year they: Tried to see a new doctor, but doctor not accepting new patients Not able to see a specialist when thought one was needed

*

Figure 8

32% 19% 17% 17% 67% 41%

Medicaid Private Uninsured Note: Includes women ages 18 to 64. *Significantly different from Private, p<.05. Source: Kaiser Family Foundation, 2004 Kaiser Women’s Health Survey.

* *

Cost can be a barrier to care for women on Medicaid

Percentage of non-elderly women reporting that in the past year they: Delayed care they thought was needed due to cost Didn’t fill prescription due to cost

*

Figure 9

Over one-third of Medicaid spending is for long-term care

Total = $270 billion

Acute Care 63% Long-Term Care 37%

SOURCE: Urban Institute Estimates based on data from HCFA/CMS Form 64 prepared for the Kaiser Commission on Medicaid and the Uninsured, 2005.

Figure 10

Medicaid spending for services, 2004

Men 26% Women 74% Men 35% Women 65%

Women comprise the majority of long-term care population

Nursing Home Residents Home Health Users Total = 1.5 million Total = 1.4 million

Note: Nursing home residents refer to those ages 65 and older. Source: Health, United States, 2005. Nursing home data from the 1999 National Nursing Home Survey. Home Health data from the 2000 National Home and Hospice Care Survey.

Figure 11