The Michigan Healthcare Marketplace Initial Observations

1
The Michigan Healthcare Marketplace Initial
Observations

• August 22, 2005
• Eileen Ellis
• Health Management Associates

2
What Do We Know and What Do We Need to Learn?

• Who is insured/covered in Michigan?
• How are they insured?
• Who is without insurance/coverage?
• Why are they uninsured?
• What characteristics of the Michigan insurance
  market impact the rate of insurance?
• How does insurance regulation impact todays
  market and impact options for the future?

3
Sources of Information

• Data that will be reviewed by CRHOP and the Data
  Workgroup
• Household survey
• Employer survey
• National Sources with State data
• Current Population Survey (CPS) (new data
  available next month)
• Medical Expenditure Panel Survey
• Snapshots of Americas Families (Urban Institute)
• Models workgroup will use OFIS data on the
  Michigan insurance marketplace

4
Overview of Coverage in Michigan in 2003
Source Kaiser State Health Facts
5
Managed Care In Michigan in 2004

• Group Coverage
• Individual
• Medicare Comp.
• Medicaid/SCHIP
• Other
• HMO Total

• 1,731,000
• 12,000
• 21,000
• 889,000
• 10,000
• 2,796,000

HMO penetration in Michigan in 2003 was 26.7 per
Kaiser State Health Facts, versus 23.7 national
average. OFIS 2004 data implies increase to
about 30.
Source Michigan Office of Financial and
Insurance Services 2004 HMO Enrollment
Information
6
Employer-Based Coverage In Michigan
Source 2003 Medical Expenditure Panel Survey
(MEPS)
7
Employer-Based Coverage
Employer-based coverage is more prevalent in
Michigan.
Source 2003 Medical Expenditure Panel Survey
(MEPS)
8
Affordability of Premiums Group Coverage
In 2003 the average premium in Michigan was
similar to the national average, but the employee
share of costs was lower.
Note for single coverage the results are
similar for MI as nationally employee pays 15
in MI, and 17 nationally.
Source Kaiser State Health Facts.
9
Individual Coverage

• Michigan has guaranteed coverage through BCBSM.
• Michigan has a lower percentage covered through
  individuals plans than the national average (4
  vs 5), but has 6 more persons covered through
  groups.
• Premiums for individual policies are age-rated.
• Individual policies for family coverage may cost
  from 248 to 993 per month.

Source BCBMS Individual Care Blue hospital,
surgical and medical plan premiums, August 2005.
10
Characteristics of Non-elderly Uninsured in
Michigan 2002 2003

• Children represent 16 in MI, 20 in US.
• Employment Status
• Families with at least one full-time worker are
  63 of the uninsured in MI, 69 in US.
• Families with no worker are 22 of uninsured in
  Michigan and 19 for the US.

Estimates by Kaiser Foundation and Urban
Institute based on 2003 and 2004 CPS.
11
Income as a Predictor of Insurance Michigan
Data from 2002-2003

• Income status of Michigan insured
• Less than 100 FPL 4 (238,000)
• 100-199 FPL - 12 (702,000)
• 200 FPL or more 84 (5,086,000)
• Income status of Michigan uninsured
• Less than 100 FPL 37 (412,000)
• 100-199 FPL - 26 (292,000)
• 200 FPL or more 37 (409,000)

Note Michigan percentages nearly identical to US
average.
Estimates by Kaiser Foundation and Urban
Institute based on 2003 and 2004 CPS.