The Economic Case for Medicaid Kathleen (Kat) Stoll WV Together for Medicaid September 25, 2017

WV Medicaid Today 650,000 + enrollees 1/3 of total WV population 76% of WV kids in 2016 60% of births 39,000 seniors 130,000 blind and disabled 75% of nursing home & long-term care 45% of DRT for opioid addiction “critical tool in addiction crisis fight” Dr. Richard Frank Uninsured rate 14% in 2013 has shrunk to 5.3% in 2016

Medicaid: Strong Economic Stimulus Macro- economic benefits – good for the state economy Micro-economic benefits – financial stability for WV individuals & families

Medicaid: Benefits ALL West Virginians Macro: Creates economic stimulus & jobs as new federal dollars flow through community Supports local hospitals and health centers Saves state dollars in other state programs & services – primary payer for substance abuse treatment Micro: Workers in small business have health coverage Increases WV family’s financial stability

Why was astrology invented? So economics would seem like an accurate science.

Medicaid: Good for WV Economy Medicaid total budget: $3 billion federal/$1 billion state dollars $3 billion new fed dollars per year generates significant jobs & business activity Sense of magnitude: Medicaid expansion repeal only: 10,600 jobs lost (4,700 in health care) by 2019 $10.19 billion business output lost 2019-2023 $220 million state & local taxes 2019-2023 Commonwealth Fund, 2017 using REMI macro-economic model See: http://www.commonwealthfund.org/publications/issue-briefs/2017/jan/repealing-federal-health-reform

Medicaid: Lifeline for Rural Providers Rural hospitals financial status improved 2013- 2015 in Medicaid expansion states: uncompensated care costs fell 43% Medicaid revenue as a share of total hospital revenue rose 33% operating margins increased by 4 percentage points (difference between total revenues & operating costs) See https://www.cbpp.org/research/health/affordable-care-acts-medicaid-expansion-benefits-hospitals-particularly-in-rural

After the ACA, uncompensated care costs in West Virginia’s rural hospitals went down almost across the board. In fact, uncompensated care costs halved from almost $85 million in 2013 to about $43 million in 2015. “So we saw that those patients that didn’t have insurance, had insurance and so that was a really good thing for us and for a lot of the rural hospitals or any of the hospitals in West Virginia,” said Skip Gjolberg, CEO of St. Joseph’s hospital in Upshur County. WV Public Broadcasting March 24, 2017

Medicaid: Financial Stability for West Virginians Federal Reserve Bank of Chicago & Federal Reserve Bank of New York studies quantify positive impact Medicaid expansion associated with significant reduction in people’s unpaid bills of all types, amount of debt sent to collection agencies, & credit card debt 10 percentage point increase in Medicaid eligibility reduces personal bankruptcies by 8 percent Medicaid covered families 40% less likely to borrow money or skip paying bills to cover medical expenses See: http://familiesusa.org/blog/2016/09/medicaid-expansion-improves-people%E2%80%99s-financial-stability

katdstoll@gmail.com 304-258-3118 Kat Consulting Kathleen (Kat) Stoll katdstoll@gmail.com 304-258-3118 Kat Consulting