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What Could a Medicaid Per Capita Cap Mean for Low-Income People on Medicare?

Table 1: Number of People on Medicare receiving assistance from Medicaid, by type of assistance and by state, 2014*
State Total low-income people on Medicare who receive assistance from Medicaid % of people with both Medicare and Medicaid receiving premium and cost-sharing assistance, and other Medicaid benefits % of people with both Medicare and Medicaid receiving premium assistance only % of people with both Medicare and Medicaid in Medicare Advantage plans % of all Medicare enrollees who receive assistance from Medicaid % of all Medicaid enrollees who are low-income people on Medicare (2011)
United States 11,063,740 72% 15% 27% 20% 15%
Alabama 222,740 42% 27% 23% 22% 20%
Alaska 17,420 95% 4% NA 21% 11%
Arizona 199,180 77% 21% 59% 17% 12%
Arkansas 138,480 53% 24% 19% 23% 18%
California 1,424,500 97% 2% 37% 25% 11%
Colorado 112,220 70% 13% 26% 14% 10%
Connecticut 181,120 47% 7% 12% 28% 20%
Delaware 30,440 45% 27% 9% 16% 11%
D.C. 32,580 70% 0.2% 8% 36% 10%
Florida 819,220 49% 22% 34% 20% 18%
Georgia 330,800 46% 25% 23% 21% 16%
Hawaii 39,860 87% 12% 66% 16% 13%
Idaho 45,980 62% 19% 18% 16% 15%
Illinois 402,620 87% 10% 33% 19% 12%
Indiana 205,580 71% 6% 10% 17% 14%
Iowa 91,920 78% 11% 10% 16% 15%
Kansas 71,540 61% 18% 9% 14% 17%
Kentucky 198,640 56% 19% 9% 22% 20%
Louisiana 218,100 56% 22% 20% 27% 16%
Maine 96,480 58% 15% 7% 31% 28%
Maryland 148,480 63% 17% 9% 15% 12%
Massachusetts 320,920 92% 8% 27% 26% 17%
Michigan 330,840 84% 13% 16% 17% 12%
Minnesota 149,660 87% 11% 37% 16% 14%
Mississippi 172,020 50% 21% 11% 30% 21%
Missouri 199,400 78% 14% 20% 17% 16%
Montana 27,420 60% 20% 7% 13% 15%
Nebraska 45,340 88% 11% 11% 14% 16%
Nevada 60,200 51% 24% 20% 13% 13%
New Hampshire 35,120 64% 17% 4% 13% 20%
New Jersey 229,660 87% 13% 21% 15% 20%
New Mexico 86,000 61% 12% 21% 23% 12%
New York 900,480 80% 13% 36% 26% 14%
North Carolina 345,240 76% 22% 20% 19% 17%
North Dakota 17,540 80% 11% 6% 14% 19%
Ohio 376,040 64% 16% 23% 17% 15%
Oklahoma 124,120 81% 18% 12% 18% 14%
Oregon 128,180 63% 19% 39% 17% 15%
Pennsylvania 469,580 81% 17% 40% 18% 18%
Rhode Island 43,360 83% 13% 23% 21% 19%
South Carolina 164,720 83% 17% 35% 17% 17%
South Dakota 22,880 61% 18% 6% 14% 16%
Tennessee 285,100 54% 22% 32% 22% 18%
Texas 740,940 56% 19% 26% 20% 13%
Utah 39,620 83% 15% 37% 11% 9%
Vermont 30,880 72% 20% 3% 23% 15%
Virginia 204,900 65% 19% 32% 15% 18%
Washington 200,040 70% 14% 23% 17% 13%
West Virginia 93,240 58% 19% 10% 21% 20%
Wisconsin 180,020 86% 8% 23% 17% 13%
Wyoming 12,380 62% 16% 2% 12% 13%
NOTES: *All data are from 2014 unless otherwise noted.
SOURCE: Data from Kaiser Family Foundation analysis of Chronic Conditions Warehouse 2014, except the share of Medicaid enrollees who are low-income people on Medicare, which used Kaiser Family Foundation’s State Health Facts 2011 data.
Table 2: Demographic Characteristics of People on Medicare Who Receive Assistance from Medicaid
Compared to Others on Medicare, 2014
Demographic People on Medicare who receive assistance from Medicaid Other people on Medicare
All Under age 65 Ages 65 and older
Number of people  11,063,740 4,602,960 6,460,780 44,618,240
Gender
Female 60% 52% 66% 53%
Male 40% 48% 34% 47%
Age
Under age 65 42% 100% N/A 10%
65-74 28% N/A 48% 52%
75-84 19% N/A 32% 26%
85 and older 12% N/A 20% 12%
Race
White, non-Hispanic 56% 60% 54% 80%
Black, non-Hispanic 18% 21% 16% 7%
Hispanic 17% 13% 19% 8%
Asian 5% 2% 7% 2%
Other 4% 5% 4% 3%
SOURCE: Kaiser Family Foundation analysis of the Chronic Conditions Data Warehouse 5 percent sample of Medicare claims for 2014 (number of people, gender, and age) and Medicare Current Beneficiary Survey Cost and Use Files for 2012 (race)
Table 3. Distribution of Medicaid Spending for People Enrolled in Both Medicare and Medicaid, FY2011
Share of Beneficiaries by Medicaid Spending Level
State Enrollment Total Medicaid Spending on Services Average Medicaid Spending per Enrollee Median Medicaid Spending per Enrollee <$2,500 $2,500-
$4,999
$5,000-
$9,999
$10,000-
$14,999
$15,00-
$19,999
$20,000-
$39,999
≥$40,000
United States 7,441,812 $129,845,614,977 $17,540 $3,939 43.7% 9.8% 9.6% 6.4% 4.6% 10.8% 15.1%
Alabama 96,882 $1,327,632,854 $13,704 $1,085 60.0% 5.4% 4.8% 4.1% 3.1% 6.4% 16.3%
Alaska 14,612 $335,901,051 $22,988 $3,909 41.8% 12.4% 9.6% 4.8% 3.1% 8.8% 19.4%
Arizona 114,960 $1,763,307,549 $15,338 $4,027 8.4% 56.4% 9.6% 2.5% 1.0% 2.6% 19.5%
Arkansas 70,122 $1,307,331,572 $18,644 $6,721 36.6% 9.6% 9.3% 7.0% 5.4% 13.6% 18.5%
California 1,259,402 $16,377,204,527 $13,004 $4,380 44.9% 6.4% 13.4% 10.4% 7.1% 9.5% 8.3%
Colorado 69,375 $1,366,499,536 $19,697 $6,252 32.4% 14.8% 10.2% 6.5% 5.4% 10.4% 20.3%
Connecticut 83,209 $2,604,800,385 $31,304 $9,173 36.2% 7.4% 7.4% 5.2% 4.4% 11.5% 28.0%
Delaware 12,243 $321,790,743 $26,284 $7,127 38.1% 7.1% 9.1% 6.1% 5.4% 8.3% 25.8%
D.C. 16,228 $476,914,052 $29,388 $6,193 39.4% 8.3% 7.1% 3.6% 2.9% 12.0% 26.7%
Florida 368,833 $5,703,485,693 $15,464 $1,743 55.0% 6.5% 6.3% 4.9% 4.1% 8.3% 14.9%
Georgia 155,676 $1,876,320,906 $12,053 $1,472 55.0% 5.6% 6.9% 5.9% 4.3% 10.5% 11.9%
Hawaii 32,171 $546,560,924 $16,989 $10,025 4.5% 4.4% 40.2% 12.2% 18.5% 7.0% 13.1%
Idaho 27,158 $449,944,335 $16,568 $5,585 40.8% 7.8% 9.8% 8.1% 7.2% 14.9% 11.4%
Illinois 324,386 $3,561,834,000 $10,980 $1,491 55.0% 6.2% 7.2% 6.0% 5.2% 14.4% 6.2%
Indiana 106,651 $2,326,994,222 $21,819 $7,220 40.5% 5.9% 7.3% 5.3% 3.8% 13.5% 23.7%
Iowa 71,106 $1,379,394,968 $19,399 $7,899 30.1% 12.5% 11.5% 8.7% 6.6% 14.2% 16.4%
Kansas 48,383 $1,012,326,827 $20,923 $12,177 28.8% 9.4% 8.6% 7.2% 6.8% 20.8% 18.3%
Kentucky 112,394 $1,550,460,641 $13,795 $2,231 58.1% 7.5% 6.7% 4.0% 2.8% 6.9% 14.1%
Louisiana 113,030 $1,652,547,395 $14,620 $1,914 52.7% 5.1% 5.2% 4.9% 5.1% 13.8% 13.3%
Maine 56,217 $1,001,899,470 $17,822 $1,402 58.7% 7.6% 5.9% 3.1% 2.2% 6.3% 16.2%
Maryland 79,917 $1,939,152,798 $24,265 $6,403 39.9% 7.6% 7.1% 5.9% 4.6% 10.0% 24.9%
Massachusetts 233,411 $5,118,787,400 $21,930 $2,634 47.9% 9.8% 6.0% 3.5% 3.6% 8.3% 21.0%
Michigan 248,567 $3,420,625,070 $13,761 $5,393 27.8% 18.8% 26.2% 8.1% 3.0% 4.6% 11.6%
Minnesota 134,578 $3,217,504,196 $23,908 $13,632 23.6% 6.5% 13.1% 8.6% 5.0% 23.4% 19.9%
Mississippi 84,255 $1,298,322,955 $15,409 $3,355 45.4% 10.7% 9.5% 5.9% 4.2% 8.8% 15.5%
Missouri 163,567 $2,467,614,937 $15,086 $4,329 43.3% 8.5% 10.2% 7.1% 5.4% 12.9% 12.6%
Montana 16,312 $361,030,574 $22,133 $5,528 39.6% 9.3% 7.7% 5.0% 3.7% 11.4% 23.3%
Nebraska 44,223 $615,812,643 $13,925 $3,117 46.7% 10.2% 8.5% 5.3% 5.2% 12.3% 11.8%
Nevada 24,248 $309,812,196 $12,777 $2,046 52.3% 6.9% 8.2% 6.5% 5.9% 8.7% 11.4%
New Hampshire 22,654 $550,487,678 $24,300 $10,227 33.5% 6.7% 9.4% 6.4% 4.9% 14.7% 24.3%
New Jersey 180,825 $3,962,973,189 $21,916 $4,300 38.5% 12.8% 6.8% 5.8% 4.5% 12.5% 19.1%
New Mexico 39,079 N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A
New York 720,924 $21,460,518,904 $29,768 $3,844 44.9% 7.9% 6.7% 4.0% 2.8% 8.2% 25.6%
North Carolina 259,485 $2,898,319,164 $11,170 $2,872 47.7% 10.7% 13.4% 7.1% 3.4% 9.2% 8.4%
North Dakota 12,881 $389,087,187 $30,206 $12,572 33.3% 6.6% 7.0% 5.7% 4.5% 10.9% 32.0%
Ohio 237,235 $5,792,329,344 $24,416 $11,391 31.3% 7.7% 8.8% 7.9% 5.9% 14.1% 24.3%
Oklahoma 98,462 $1,166,731,644 $11,850 $3,210 46.0% 10.6% 10.5% 7.9% 5.4% 12.6% 7.1%
Oregon 68,240 $1,368,580,769 $20,055 $4,984 26.9% 23.1% 8.7% 6.2% 5.2% 15.6% 14.3%
Pennsylvania 366,634 $6,744,434,911 $18,396 $1,904 55.9% 7.9% 4.6% 3.7% 2.8% 7.4% 17.8%
Rhode Island 35,145 $717,216,288 $20,407 $3,080 48.1% 6.2% 6.9% 4.7% 3.8% 15.8% 14.5%
South Carolina 137,451 $1,457,955,047 $10,607 $1,238 62.3% 8.3% 6.4% 3.9% 3.0% 6.1% 10.0%
South Dakota 13,923 $228,508,207 $16,412 $9,190 30.6% 10.4% 10.5% 8.1% 6.0% 24.5% 9.9%
Tennessee 155,658 $2,197,033,243 $14,114 $3,038 41.2% 23.9% 5.8% 4.0% 2.7% 14.2% 8.2%
Texas 396,649 $6,104,576,387 $15,390 $6,183 30.7% 16.0% 10.7% 6.9% 5.9% 19.9% 10.0%
Utah 28,586 $428,057,561 $14,974 $6,386 26.2% 10.7% 35.5% 4.8% 3.1% 6.5% 13.3%
Vermont 21,042 $249,200,762 $11,843 $4,734 38.0% 13.3% 13.5% 7.3% 6.2% 16.4% 5.4%
Virginia 127,154 $2,062,459,965 $16,220 $1,926 52.9% 6.9% 6.2% 4.5% 3.5% 11.0% 15.1%
Washington 132,239 $1,932,007,998 $14,610 $3,123 48.2% 5.5% 7.6% 7.1% 5.8% 14.8% 11.0%
West Virginia 51,358 $902,321,881 $17,569 $1,360 55.1% 4.7% 5.6% 4.1% 4.0% 9.4% 17.1%
Wisconsin 146,766 $3,306,837,031 $22,531 $5,531 38.7% 10.3% 6.4% 4.0% 2.8% 8.7% 29.1%
Wyoming 7,306 $234,163,399 $32,051 $16,386 24.6% 6.1% 9.7% 7.7% 6.4% 14.5% 30.9%
NOTES: Spending amounts excludes premiums.  Due to the unavailability of 2011 data, 2010 MSIS data were used for Florida, Kansas, Maine, Maryland, Montana, New Mexico, New Jersey, Oklahoma, Texas, and Utah, and then adjusted to 2011 CMS-64 spending levels. Excludes spending for New Mexico due to data quality issues.
SOURCE: KFF and Urban Institute estimates based on data from FY2011 MSIS and CMS-64 reports.
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