1. Joint Meeting of Selected and Interested Community Leadership January 22, 2013 Bosque Theater, Waco, Texas

2. How did we get here? Unfunded Uninsured/Underinsured – ever growing segment Unsustainable Trajectory Excessive cost/person – 40% greater Rising incidence of Chronic Disease Access to Care/Provider Shortage Excess Care – Often do what patient wants, not just what they need – (quantity not quality)

3. 72 Million

4. Where are the Uninsured?

5. 6.1 Million

6. 45,800

7. $1 Cost $.12 $.88 $1 Cost $.27 $.73 $1 Cost $.99 $.01 Medicaid Gap

8. $1.70 $1 Cost

9. Healthcare is Changing!

10. Affordable Care Act Law Upheld by the Supreme Court Changes already in effect Additional components going into effect over the next few years States allowed to decide on Medicaid Expansion Currently…Texas position is not to expand

11. Medicaid Overview - Texas Medicaid Covers – 4.3 Million Texans 16% of Population Medicaid Enrollees Elderly and Disabled 55% of expenditures 23% of total enrollees Children 35% of expenditures 64% of total enrollees

12. Medicaid Expansion Expansion Requirement: Coverage for 133% of FPL 1.1 Million additional Medicaid enrollees under expansion Under the ACA, the Federal Government Pays 100% of Medicaid Expansion for 3 years Reduced in stages to 90% by 2020 $5.7 Billion in State Revenue, equals… $65.6 Billion in Federal Funding (10yrs)

13. Medicaid Expansion Reality: Texans are already paying for this… Federal taxation is not changed based on participation Texas would not get this “return” Perryman Group Study: Expansion could result in a $250 billion boost to the Texas economy Local Impact: Over 27,000 additional local residents would gain access to appropriate healthcare – “coverage” equates to better health status

14. Federal Insurance Exchanges Large Number of Texans will be eligible based on criteria Provides more affordable coverage for patients who were uninsured or underinsured If State of Texas decides not to provide state-run exchange, Feds will

16. McLennan County 37,000 total Medicaid enrollees Potentially 27,000 additional Medicaid enrollees with expansion 45,794 uninsured (23.1% of the population) 14,000 uninsured would be eligible for subsidies through the Exchanges Ranked 133 out of 221 largest Texas counties based on health factors (countyhealthrankings.org)

17. Thank You!