# Presentation: 498973

## Trends in the Uninsured: Impact and Implications of the Current Economic Environment

**Paula Roy**
**Executive Director,**
**Delaware Health Care Commission**

**Notes:**
Paula Roy’s slides for “Trends in the Uninsured: Impact and Implications of the Current Economic Environment.” 

Paula Roy is the Executive Director of the Delaware Health Care Commission.

## Understand Nationally;  Act Locally

**Understand Nationally;  Act Locally**
**States Need to Collect Own Data**

**Notes:**
National data are useful because they help put a State in context.  It is important to know if one State is experiencing some of the similar problems that other people in other places are. But it is also just as important to understand what is happening on a State level. It is necessary to understand the economic drivers in a State, what the employment situation is like, and what a particular State’s problems are in order to craft a workable, State-specific solution. 

## Community HealthcareAccess Plan

**Community ****Healthcare****Access Plan**

**State Planning**
**Project**

- Paving the Way to a Healthier Delaware:
- An Uninsured Action Plan

**Notes:**
Delaware has used State and some Federal funding, including a State Planning Grant from the Health Resources and Services Administration, to develop a program called the Uninsured Action Plan to examine its own situation in depth. 
The grant has allowed Delaware to gather all sorts of information about the situation in the State, including demographics of the uninsured and the impact of healthcare costs on the system and the individual. 
In addition, as a result of a Federal community access program grant, Delaware is putting together a service delivery model that helps identify low-income, uninsured people who are not eligible for an existing program and matches them up with a health home. This program will obtain information about how the uninsured access care and give the State the opportunities to stress the importance of a regular source of care.  

## 99,000Uninsured

**99,000****Uninsured**

**Notes:**
Looking at the data allowed the State to form a picture of who exactly are Delaware’s uninsured. Of the 99,000 uninsured in Delaware, 75% are working, 18% are children, and 66% own or are in the process of buying their own home. 

## 99,000Uninsured

**99,000****Uninsured**

**Notes:**
The picture that emerged of the Delaware uninsured was complicated, and showed that there may not be one easy answer. 80% of the uninsured have incomes above the Federal poverty level, and 25% are eligible for existing programs, but not enrolled. 

## Health Care Cost Increases Threaten Status Quo

**Good Data  =  Good Decisions**
**Prevent further Erosion**

**Notes:**
Even though the current recession will prevent States from taking immediate action, it is still useful for them to take an in-depth look at their own uninsured population. States need to be prepared to take action when the economy does increase to prevent further erosion of insurance coverage and the healthcare system, and having good data is essential for making good decisions. 

##   Insurance Market

**  ****Employer Pressures**
**  ****Costs**
**  ****Uninsured**

**Notes:**
In order to better understand their own situation, States need to understand what is going on in their own State, including being aware of trends in the insurance market and unemployment rates as well as economic drivers.  

## The Challenges...

-  Health Costs Are Increasing
-  Limited State Resources
-  Lack of Flexibility With Federal Funds *     (*Health Insurance Flexibility & Accountability -HIFA)
-  Numerous Values/Points of Reference
-  Politically Challenging 	~ Solutions May Appear In-Equitable!!

**The Challenges...**

**Notes:**
States should be prepared to face some challenges as they address the issue of the uninsured. Since the uninsured population is very diverse, there is not going to be one single solution. Other challenges including increasing costs, limited State resources, lack of flexibility with Federal Funds, and politics will all prove challenging for States that address the issue.