1 Impact of Reform on Sources of Insurance and Hospital Finance Stephen A. Frayne Senior Vice President, Health Policy Connecticut Hospital Association September 21 and 30, 2011

2 90 3% 33 1% 322 9% 536 Medicare 16% 343 Uninsured 10% Total: 1,324 39% FFSSAGAManaged 2,113 Private Insurance 61% Balancing Connecticut Hospital Finances 2008 Population by Insurance Type (in Thousands)

% 71 2% % 571 Medicare 16% 380 Uninsured 11% Total: 1,526 43% FFSSAGA (MLIA) Managed 2,059 Private Insurance 57% Balancing Connecticut Hospital Finances May 2011 Population by Insurance Type (in Thousands)

4 $-270 Medicare $-137 Uninsured $+1,075 Private Insurance +3% $ -810 Margin -19% Medicaid $-403 $-145 $-117 $-141 FFS MLIA Managed Margin +25% 2010 Balancing Connecticut Hospital Finances (in millions)

5 Connecticut After Reform –2014 Uninsured and Medicaid Enrollment 2014 Health Reform 762,000- 1,026,000 Uninsured 334, ,000 Medicaid 395, ,000 SAGA 33, ,000 Exchange Commercial 111, ,000 Medicaid 507, ,000 Uninsured 110,000 – 126,000 Illegal Aliens

Uninsured 3%-4% 571 Medicare 16% 2,397-2,186 Private Insurance/Exchange 67%-61% Connecticut Population by Insurance Type – After Reform Based on Lower Estimate of Medicaid Enrollment 2014 Total: 1,188- 1,399 33%-39% Medicaid 14%-20%

7 $-1,012 Medicare $-97 Uninsured $+1,404 Private Insurance Projection 2014 Balancing Connecticut Hospital Finances (in millions) -4.5% $-1858 Margin -44% $-749 Medicaid Managed Care Margin +25%