Linda Katz – RI Future

September 13, 2016

More Rhode Islanders have health insurance coverage thanks to health care reform

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New Census data show that the percentage of uninsured Rhode Islanders was 5.7 percent in 2015, half the rate it was in 2013, the year before the Affordable Care Act (ACA) went into effect. In 2014, 7.4 percent were uninsured.

Two new avenues for affordable health insurance made available through the ACA have helped significant numbers of Rhode Islanders gain coverage. First, new Medicaid eligibility for adults (Medicaid expansion) allowed around 60,000 single adults with income marginally above the poverty line to have health insurance coverage.

Second, the new state exchange, HealthSourceRI, provided a pathway to coverage for another 35,000 Rhode Islanders who purchase private insurance. Almost 90 percent of enrollees, those with income below four times the poverty level, quality for federal tax credits to help pay their monthly premium. The majority of enrollees (60 percent) have income below two and half times the poverty level ($29,000) and also receive assistance paying for out of pocket costs including co-pays and deductibles. (Source: HealthSourceRI, Open Enrollment 2016)

According to the Rhode Island Annual Medicaid Expenditure Report for SFY 2015, the federal/state Medicaid program provides health insurance to one in four Rhode Islanders. In addition to the 60,000 newly eligible single adults, 150,000 children and families with lower income and 12,000 children with special health care needs have comprehensive insurance through Medicaid. Seniors (19,000) and people with disabilities (32,000) rely on Medicaid for the services they need to live safely in the community or in a facility when home-based care is not feasible.

“Rhode Islanders should be proud that we are 7th in the nation for the percent of residents who have health insurance coverage”, said Linda Katz, Policy Director at the Economic Progress Institute. “With health insurance, people are more likely to keep up with yearly preventive care visits and people with chronic conditions can get the treatment they need to promote their well-being. Besides the obvious benefits for families and individuals, having a healthy work force is a good selling point for our state. Medicaid and coverage through HealthSourceRI are vital to ensuring that thousands of our residents can afford comprehensive health insurance.”

May 12, 2015May 13, 2015

Medicaid on the Move

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The 7th Annual Budget Policy Conference, a fundraiser for the Economic Progress Institute (EPI), had a timely theme: “Medicaid on the Move.”

Since Governor Gina Raimondo announced a Medicaid crisis in February and the creation of a working group of “27 members from across health care, business, state government and community and nonprofit organizations” to deal with the crisis, the idea of “Reinventing Medicaid” has become a central part of the state’s 2016 budget process.

Medicaid is a state and federally supported system of health care that targets the most vulnerable and least represented people in our community, i.e. children, low income adults, the elderly and those with mental or physical handicaps. So special attention must be paid to the process of “reinventing” the system and therefore an appropriate target for a progressive economic institute such as EPI to address.

Governor Raimondo gave the opening address to the breakfast crowd, mostly made up of medical policy wonks and EPI supporters. She used the opportunity to press for a $10.10 minimum wage and for an increase in the earned income tax credit from 10 to 15 percent, possibly her two most progressive ideas in her 2016 budget proposal.

Moving onto Medicaid, Raimondo insisted that her goal in pulling together the working group is “not about kicking people off Medicaid” but “getting people cared for in the lowest cost environment.”

Raimondo acknowledged that the EPI and many of those in the audience are more concerned with social justice and economic justice than they are with short term budget fixes when she said, near the end of her speech, “Your stubborn idealism is a good thing for Rhode Island, so don’t lose it.”

Linda Katz, policy director and co-founder of the EPI, spent 14 minutes introducing the audience to the basic facts about Medicaid. In the video below I’ve combined the slides from her presentation with the talk she gave.

Katz is a member of the Reinventing Medicaid working group. The first weeks of work by the working group, Katz suggested, was preliminary. Now, as the working group prepares to move ahead and plan the implementation of the ideas presented, Katz says that she’s “looking forward to part two, where we take a deeper dive into Medicaid.”

Cindy Mann, former Medicaid Director in the Obama Administration, began her talk noting that this July will mark the 50th anniversary of Medicaid. Medicaid, says Mann, “is constantly reinventing itself.”

Over the course of her talk Mann explained exactly who Medicaid serves, and why Rhode Island is in many ways both an outlier and a leader in the way we administer the program. In the video below I’ve combined the slides from her presentation with the talk she gave.

For instance, “Rhode Island has, as a population, more elderly and disabled” than many other states, said Mann. Three percent of our Medicaid enrollees account for 70 percent of our Medicaid spending.

Mann made a special point to mention the medical care of the incarcerated, surely the population our society seems least vested in. When people in our prisons require outpatient care, that is, medical services the prison hospital is unable to meet, Medicaid covers the expense. Mann maintained that the state should make sure that “no one leaves jail without being assessed for health care coverage.”

Former Lt. Governor Elizabeth Roberts, who Governor Lincoln Chafee tasked with setting up the state’s health care exchange and who Raimondo put in charge of the working group, spoke last.

Roberts said that she and the working group instead worked to reform the system. “We did not remove benefits,” said Roberts. In addition to the recommendations of the working group, Roberts feels that there needs to be a pay increase for certified nursing assistants and home health care workers, who are being squeezed economically.

Roberts also agreed with Katz about the second phase of the working group’s mission. The “next 2 months,” said Roberts, “will be more important than the last 2.” The working group issues its final report in July.

February 23, 2012February 23, 2012

Cutting low income dental care costs as much as it saves

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linda katz — LInda Katz, the executive director of the Economic Progress Institute, at a recent conference.

Making budget cuts to low income dental care may sound like a good way to save money but it will actually cost the state slightly more than it will save, says Linda Katz, the executive director of the newly named Economic Progress Institute.

That’s because, she said, for every dollar the state spends on low income medical assistance the federal government provides matching funds.

So while the state would save $2.6 million by cutting low income dental care for the tens of thousands of Rhode Islanders who make use of this program, the Department of Human Services would actually lose more than $5.2 million in funding. More than $5.2 million because the feds actually match $.52 on the dollar, Katz said.

“It’s easy to talk about raw numbers,” she said. “But you have to understand what is behind those numbers.”

At a presentation last week, Katz said for the last few budget cycles those on the right have talked about making cuts health and human services spending because it has gone up 72 percent over the past decade while the overall state budget has only increase by about 40 percent.

While that’s true, much of that increase to health and human services comes in the form of federal dollars.

Consider food stamps, for example. Yes, the state distributes some $298 million worth of food stamps, but 99 percent of those dollars comes from the federal government, Katz said.

Given that food stamp spending has gone up some 368.5 percent over the past ten years, according to her presentation, it accounts for a significant increase in the health and human services spending in Rhode Island, but almost all of it comes from the federal government, rather than directly from Rhode Island taxes.

Of course, the vast majority of the increases to health service spending has been in providing medical benefits. But this increase has mirrored the increases in the private sector, Katz said. Citing a Kaiser study, she said family medical coverage has increased 11 percent over the past ten years.

“The same factors that are driving up costs in the private sector are driving up costs in the public sector as well,” she said.

These increased costs should be something that Rhode Island is willing to absorb.

“Certainly everybody should have access to high quality affordable health care,” she said.

February 15, 2012February 15, 2012

TOMORROW: 5th Annual Budget Rhode Map Conference

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Register now for The Poverty Institute‘s 5th Annual Budget Rhode Map Conference “From Poverty to Progress” to hear from leading experts about the economic vitality of Rhode Island and its residents.

Thursday, February 16, 2012

8:30 am: Registration and Continental Breakfast

9:00 am – 12:30 pm: Conference

Rhodes on the Pawtuxet

60 Rhodes Place, Cranston, RI 02905

$35 per person

Register Now!

Featuring keynote speaker Jared Bernstein

Senior Fellow, Center on Budget and Policy Priorities

Former Chief Economist and Economic Advisor to Vice President Biden and member of President Obama’s economic team.

Additional Presentations Include:

A Skilled Workforce: Meeting the Demands of the Innovation Economy

Julian L. Alssid, Executive Director, Workforce Strategies Center
Rick Brooks, Executive Director, Governor’s Workforce Board
Keith Stokes, Executive Director, RI Economic Development Corporation
Adriana Dawson, State Director, RI Small Business Development Center

Rhode Island’s Human Service Budget: The Story Behind the Headlines

Elena Nicolella, Rhode Island Medicaid Director
Linda Katz, Policy Director, The Poverty Institute