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PCG Utah Medicaid Expansion Analysis

PCG Utah Medicaid Expansion Analysis

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Published by Eric Ethington
State of Utah Medicaid Expansion Assessment
State of Utah Medicaid Expansion Assessment

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Published by: Eric Ethington on May 23, 2013
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12/09/2013

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State of Utah Medicaid Expansion Assessment 
Utah Impact: 2014-2023
1
 
State of UtahMedicaid Expansion Assessment
Impact Analysis: 2014-2023
 
 
State of Utah Medicaid Expansion Assessment 
Utah Impact: 2014-2023
2
Table of Contents
 I.
 
Executive SummaryII.
 
Five Modeled Scenarios SummaryIII.
 
PCG Medicaid Expansion Simulation Model Resultsa.
 
PCG-MESM Assumptions and Modeling b.
 
Mandatory Expansionc.
 
Optional Expansiond.
 
Woodwork and Mandatory Expansione.
 
Crowd-Outf.
 
Opportunity Costsg.
 
Administrative Costs and Savingsh.
 
Uncompensated Care Savingsi.
 
Public Assistance Savings j.
 
Medically Needy Savingsk.
 
Estimated RevenuesIV.
 
Appendixesa.
 
Appendix I: Public reports participation and take-up rate assumption summarychart b.
 
Appendix II: MAGI explanationc.
 
Appendix III: Medicaid and Essential Health Benefit comparisond.
 
Appendix IV: Utah FMAP Historical Charte.
 
Appendix V: Per Member Per Month Figuresf.
 
Appendix VI: Other States Expansion Study Comparisong.
 
Appendix VII: Tax Revenue Allocationh.
 
Appendix VIII: Detailed Tax Information
 
 
State of Utah Medicaid Expansion Assessment 
Utah Impact: 2014-2023
3
Executive Summary
In June of 2012 the United States Supreme Court ruled that the Affordable Care Act (ACA)requirement that states expand their Medicaid programs to an entirely new population group wasunconstitutional. Thus states were allowed to keep their current federal Medicaid fundingregardless of whether or not they choose to expand Medicaid.Following this ruling many states, including Utah, identified a need to determine if expandingMedicaid would be beneficial to the state. As part of its efforts in this regard, the UtahDepartment of Health (DOH) contracted with the Public Consulting Group (PCG) to model and project the impacts of expanding or not expanding
Utah’s
Medicaid program.The following report estimates Medicaid enrollment and costs and savings in Utah under multiple scenarios and with differing populations. The estimations include:
 
The costs of the current program projected into future years,
 
The costs of the “mandatory
changes
” due to eligibi
lity determination conversion,
 
The costs of expanding Medicaid to two different federal poverty level (FPL) groupings
 – 
 0-100% FPL and 0-138% FPL,
 
The costs of 
the “woodwork” effect,
 providing coverage to the population currentlyeligible for Medicaid but not enrolled,
 
The crowd out effect
 – 
those who drop private coverage due to an expansion in publiccoverage,
 
Opportunity costs
 – 
the modeled losses to public health and well being if the opportunityto expand is not taken,
 
Uncompensated care savings
 – 
the decrease in the amount of unreimbursed care hospitalsand other providers must face due to an increase in Medicaid coverage for the uninsured,
 
Public assistance savings
 – 
the need for less expenditures by state and local governmentson programs to assist the indigent and uninsured as they gain Medicaid coverage,
 
Medically needy savings
 – 
the gain or loss of revenue to the state as those on the currentMedically needy program leave the program and enroll in expanded Medicaid, and
 
Anticipated revenues
 – 
the effect the increased federal and state spending that wouldoccur under Medicaid expansion would have on the economy of Utah.

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