State Information and Statistics

 

Demographics

State Affiliation

State Population (2011)

Uninsured Population
(FY2010)

Total Medicaid Enrollment
(FY2010)

MC Enrollment
(FY2011)

CHIP Enrollment
(FY2010)

Connecticut

3,529,100

320,133

712,350

571,020

21,033

Maine

1,311,400

133,065

410,743

267,012

32,994

Massachusetts

6,526,500

285,717

1,690,693

1,067,929

142,279

New Hampshire

1,298,400

145,013

167,560

221,168

10,630

Rhode Island

1,036,800

126,184

216,302

183,433

23,253

Vermont

620,000

49,880

196,412

112,831

7,026

 

Notes: Percentages may not sum to 100% due to rounding effects. For more details, see "Notes to Topics Based on the Current Population Survey (CPS)" at http://www.statehealthfacts.kff.org/methodology. Population and demographic data on are based on analysis of the Census Bureau’s March 2011 and 2012 Current Population Surveys (CPS; Annual Social and Economic Supplements) and may differ from other population estimates published yearly by the Census Bureau. U.S. and state population data displayed on this site are restricted to the non-institutionalized, civilian (not active duty military) population; state data represent 2-year averages.

Sources: Urban Institute and Kaiser Commission on Medicaid and the Uninsured estimates based on the Census Bureau's March 2011 and 2012 Current Population Survey (CPS: Annual Social and Economic Supplements). U.S. Census Bureau, 2010 American Community Survey, Table S2701, available at: http://www.census.gov/hhes/www/hlthins/data/acs/aff-2010.html

Spending

State Affiliation

Federal Matching Rate FY2012

Medicaid Payments Per Enrollee
FY2010

Spending on Acute Care
FY2009

Spending on Long Term Care
FY2009

Average Annual Growth in Medicaid Spending
(2007-2009)

Connecticut

50.00%

$7,561

$2,379,225,894

$3,333,013,744

17.8%

Maine

63.27%

$5,968

$1,690,381,633

$776,152,002

12.4%

Massachusetts

50.00%

$6,841

$8,820,234,886

$3,660,409,543

10.1%

New Hampshire

50.00%

$6,748

$523,403,426

$572,468,950

6.7%

Rhode Island

52.12%

$8,229

$1,194,365,473

$576,629,934

4.7%

Vermont

57.58%

$6,158

$546,291,968

$391,992,978

3.8%

 

Sources: Urban Institute and Kaiser Commission on Medicaid

Notes: FY2012: Effective from October 1, 2011 to September 30, 2012

 

Duals (Medicare)

State Affiliation

Duals Eligible Enrollment  (2007)

Duals as a % of Aged & Disabled Medicaid Enrollees    (2007)

Spending per Dual Eligibility
Long-Term Care (2007)

State Medicaid Spending on Prescribed Drugs (2007) 

(In Millions)

*Annual Payments based on Revised NHE (2006)

Connecticut

100,257

75%

$1,970

37

$112,079,205

Maine

88,600

76%

$626

11

$40,889,787

Massachusetts

250,744

43%

$2,865

37

$216,797,916

New Hampshire

27,773

74%

$408

4

$27,632,378

Rhode Island

39,236

60%

$516

6

$37,654,242

Vermont

31,217

75%

$335

10

$16,672,538

*Notes: These are original and revised annual state "clawback" payments from CMS based on December 2005 actual enrollment of Medicaid and Medicare dual eligibles. They represent the payment amounts that states will be assessed to finance a portion of Medicare Part D for each dual eligible during 2006. The newly updated National Health Expenditures (NHE) growth rate in per capita prescription drug spending between 2003 and 2006 was used by CMS in the calculation of the new clawback figures. The total percentage reduction in annual payments is -9.66%. For more details about the Clawback, see KCMU''s "The ''Clawback:'' State Financing of Medicare Drug Coverage," available at http://www.kff.org/medicaid/7118a.cfm.

Sources: Urban Institute estimates based on data from the Medicaid Statistical Information System (MSIS) and Medicaid Financial Management Reports (CMS Form 64) prepared for the Kaiser Commission on Medicaid and the Uninsured. Available at: http://www.kff.org/medicaid/7846.cfm.

An Update on the Clawback: Revised Health Spending Data Change State Financial Obligations for the New Medicare Drug Benefit, Table 2, Kaiser Commission on Medicaid and the Uninsured (KCMU), March 2006. Available at http://www.kff.org/medicaid/7481.cfm.

Definitions

Dual Eligibles are individuals entitled to Medicare who are also eligible for some level of Medicaid benefits.

CMS: The Centers for Medicare and Medicaid Services

Clawback: The mechanism through which the states will help finance the new Medicare drug benefit is commonly referred to as the "clawback," the statutory term for which is "phased-down state contribution."

NHE: The National Health Expenditures growth rate in per capita prescripton drug spending between 2003 and 2006 is used to calculate the state contribution for dual eligibles in Medicare Part D. For details about the NHE from CMS, see http://www.cms.hhs.gov/NationalHealthExpendData/".

KCMU: The Kaiser Commission on Medicaid and the Uninsured

 

MMIS Procurement (As of April 27, 2012)

State Affiliation

MMIS Vendor

MMIS Status

Medicaid Procurement
Website

 

 

Connecticut

Current - HP Enterprise Svcs
(current contract ends 10/01/2014 with an additional three 1-year extension )*

Current - HP Enterprise Svcs

Connecticut

 

 

Maine

Current - Molina Information Sysems (MMIS) through 12/31/14

Current - Molina Information Systems

Maine

 

 

Massachusetts

State Operated
(5/25/05 -3/1/11)

Contract end with option years(6/1/15)*

Current - State Operated

Option years 4

Massachusetts

 

 

New Hampshire

Current -HP Enterprise Svcs
(current contract extension through 7/01/12)*

Current - HP Enterprise Svcs

* 23-month contract ext

New Hampshire

 

 

Rhode Island

Current - HP Enterprise Svcs
(current contract through 6/30/09 with 2 option years)*

Current - HP Enterprise Svcs

Update
pending

Rhode Island

 

 

Vermont

Current-HP Enterprise Svcs
(current contract ends 12/31/08 with 3 option years)*

Current - HP Enterprise Svcs

MMIS RFP issueded December 2010
Update
pending

Vermont

 

 

*Sources: http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Data-and-Systems/Downloads/MMISFACSR.pdf

 

Waivers

State Affiliation

      MR/MD       (2007)

         Aged          (2007)

Aged &
    Disabled     (2007)

Physically
    Disabled     (2007)

Children

Connecticut

234

N/A

12,587

741

N/A

Maine

2,750

N/A

1,300

186

N/A

Massachusetts

11,978

8,934

N/A

N/A

N/A

New Hampshire

2,651

3,128

N/A

N/A

N/A

Rhode Island

3,394

946

2,279

120

N/A

Vermont

N/A

N/A

N/A

N/A

N/A

 

Waivers (continued)

State Affiliation

HIV/AIDS

Mental Health

      TBI/SCI       (2007)

Total
All Waivers (2007)

 

Connecticut

N/A

N/A

360

13,588

 

Maine

N/A

N/A

N/A

4,236

 

Massachusetts

N/A

N/A

90

21,008

 

New Hampshire

N/A

N/A

118

5,922

 

Rhode Island

N/A

N/A

N/A

6,738

 

Vermont

N/A

N/A

N/A

N/A

 

Sources: The Kaiser Commission on Medicaid and the Uninsured (KCMU) and The University of California at San Francisco's (UCSF) analysis based on The Centers for Medicare & Medicaid Services (CMS) Form 372, December 2009, Table 5. "Medicaid 1915(c) Home and Community-Based Service Programs: Data Update" available at http://www.kff.org/medicaid/7720.cfm.

Definitions

N/A: No waiver offered. 1915(c) Home and Community-Based Service

Waiver: Serves as one of three main ways a state can provide Medicaid home and community-based services. The other two are Personal Care Services and the Home Health Benefit.

MR/DD: Mental Retardation and Developmental Disabilities

TBI/SCI: Traumatic Brain and Spinal Cord Injury

 

 

 

 

 

 

NESCSO Project Highlights

New England States Collaborative Insurance Exchange Systems
NESCSO has developed a resource guide for you to be able to contact your colleagues in the other states to discuss questions or issues that you may have.

Follow the link to the Health Insurance Exchange - New England Directory of Key Staff: NESCIES Contact Guide February 2013

New England Regional HIE Collaborative
For additional information, please contact Brenda Harvey at brenda.harvey@umassmed.edu.

NESCSO Regional Data Warehouse
The New England States Consortium Systems Organization (NESCSO) is developing a regional data warehouse to provide New England states the ability to conduct timely comparative analyses for the effective and efficient administration of the states’ Medicaid State Plans and to support the regional initiatives of the NESCSO members. Click here for more information.

New England State Links

CMS/HIX Updates

CMS has released the business service definition (BSD) to be used by the Federally-facilitated Exchange for the Determine Medicaid and Tax Households Business Service Definition for posting on CALT.  This BSD defines the individual’s Medicaid and Tax Household when an application for insurance affordability programs is submitted to the Exchange.  This business service includes implementation of rules to achieve the following results:

  • Each tax filer’s Tax Household, using data for the appropriate coverage year(s).
  • Each applicant’s Medicaid Household, based upon Tax Household, tax filing status and other family information for the appropriate coverage year.
  • Guidance and exception messages when a Medicaid or Tax Household cannot be determined for the applicant.

The BSD can be found with other FFE Eligibility/MAGI BSDs in the Exchange Eligibility and Enrollment Guidance folder in CALT.

The intended audience for this BSD includes state business, technical, governance, and project management stakeholders.  Specific users should include software or system developers and testers.

 

Web Resources