2017 FACT BOOK - Texas Health and Human Services · 2017-02-10 · 4 2017 Texas HHS Fact Book I — Budget A. State Budget, State Fiscal Year (SFY) 2017 (in millions) Note: Figures

2 0 1 7

BOO

KFA

CT

2017 Texas HHS Fact Book 1

I. Budget ..............................................................3

II. Population .......................................................6

III. Programs .......................................................24

Table of Contents

For Additional Information Please Contact

Texas Health and Human Services CommissionGovernment and Stakeholder Relations

(512) [email protected]

Texas Health and Human Services Website:www.hhs.texas,gov

2 2017 Texas HHS Fact Book


I — BudgetA. State Budget, State Fiscal Year (SFY) 2017 ............................................4

B. HHS Budget Requests, By Funding Sources, SFYs 2018-2019 ......4

C. HHS Agencies Budget Requests, By Funding Sources, SFYs 2018-2019 ......5


I — Budget

A. State Budget, State Fiscal Year (SFY) 2017 (in millions)

Note: Figures include employee benefits. Figures include the assumption of a supplemental appropriation for FY 2017 for the HHS agencies.

Source: January 2017, Legislative Budget Estimates. House Bill 1 (HB1). Legislative Budget Board.

Notes: Totals may not add up due to rounding. Amounts include exceptional items as of September, 2016. With the consolidation of HHS system agencies required by Sunset

legislation passed by the 84th Legislature, the transformed Texas Health and Human Services system consists of three agencies in the 2018-19 biennium, the Texas Health and Human Services Commission, Texas Department of State Health Services, and Texas Department of Family and Protective Services.

Source: Agency FY2018-2019 Legislative Appropriations Requests (LARs).

B. HHS Budget Requests, By Funding Sources, SFYs 2018-2019 (in millions)

State Federal & Other Total

SFY 2018

dollars $18,155.4 $24,191.7 $42,347.2

percents 43% 57% 100%

SFY 2019

dollars $19,322.6 $25,702.3 $45,025.0

percents 43% 57% 100%

SFY 2018-2019

dollars $37,478.0 $49,894.0 $87,372.2

percents 43% 57% 100%

Health & Human Services

All Other Government

Functions

SFY 2017 State

Budget

General Revenue

dollars $17,338.9 $36,731.7 $54,070.6

percents 32% 68% 100%

General Revenue-Dedicated

dollars $584.1 $3,404.6 $3,988.7

percents 15% 85% 100%

All Funds

dollars $41,299.0 $67,288.7 $108,587.7

percents 38% 62% 100%


C. HHS Agencies Budget Requests, By Funding Sources, SFYs 2018-2019 (dollars in millions)

Agency GR /GRD

Federal & Other Total FTEs

SFY 2018

HHSC $16,594.1 $22,912.8 $39,506.9 41,721

DSHS $368.0 $471.7 $839.8 3,295

DFPS $1,193.3 $807.2 $2,000.5 13,753

TOTAL $18,155.4 $24,191.7 $42,347.2 58,768

SFY 2019

HHSC $17,735.5 $24,414.9 $42,150.5 41,883

DSHS $347.2 $469.2 $816.4 3,295

DFPS $1,239.9 $818.1 $2,058.1 13,872

TOTAL $19,322.6 $25,702.3 $45,025.0 59,050

I — Budget

Notes: Totals may not add up due to rounding. Amounts include exceptional items as of September, 2016.

With the consolidation of HHS system agencies required by Sunset legislation passed by the 84th Legislature, the transformed Texas Health and Human Services system consists of three agencies in the 2018-19 biennium, the Texas Health and Human Services Commission, Texas Department of State Health Services, and Texas Department of Family and Protective Services.

Source: Agency FY2018-2019 Legislative Appropriations Requests (LARs).


A. Selected Demographic / Socioeconomic Indicators .........................7

B. Texas Population, 2010-2020, By Year .................................................................7

C. Texas Population, 2010-2020, By Year, By Race/Ethnicity ...........................................8

D. Texas Population, 2010-2020, By Year, By Age Group ...................................................9

E. Texas Population, 2010-2050, By Decade........................................................10

F. Texas Population, 2010-2050, By Decade, By Race/Ethnicity .......................10

G. Texas Population, 2010-2050, By Decade, By Age Group ..............................12

H Fifteen Most Populous Texas Counties, By Rank, 2015 ..................................14

I. Fifteen Least Populous Texas Counties, By Rank, 2015 ..................................15

J. Ten Most Populous States, By State, Rank, Total Population, And Race/Ethnicity, July 1, 2015 ..............................16

K. Top Ten States By Change in Total Population Projection, By State,

Rank, And Population 65 And Older, 2010 To 2040 .........................................17

L. Texans By Poverty Income Status, By Race / Ethnicity, Age and Citizenship Status,

2015 .....................................................................18

M. Health Insurance ..............................................19

II — Population


A. Selected Demographic / Socioeconomic Indicators

Indicators Texas US

Total Population(in millions, projected for 2017) 1 28.8 326.6

Percent Change in Population (April 1, 2010 to July 1, 2020) 1 21.5% 8.1%

Average Annual Population Growth 1 2.0% 0.8%

Median Household Income 2 $55,653 $55,775

Percent of Population Below Poverty 2 15.9% 14.7%

Percent of Under 18 Population Below Poverty 2

23.0% 20.7%

Percent of Population Uninsured 2 17.1% 9.4%

Percent of Under 18 Population Uninsured 2 9.5% 4.8%

Sources: 1 US Census Bureau. Population Division, National Population Projections, released 2014. Texas Demographic Center at UT San

Antonio. Population Migration Growth Scenario 2000-2010, released 2014.

2 US Census Bureau. American Community Survey, 2015.

B. Texas Population, 2010-2020, By Year

Year Texas Population Percent Change

2010 25,145,561 -

2011 25,631,695 1.9%

2012 26,130,047 1.9%

2013 26,640,165 2.0%

2014 27,161,942 2.0%

2015 27,695,284 2.0%

2016 28,240,245 2.0%

2017 28,797,290 2.0%

2018 29,366,479 2.0%

2019 29,948,091 2.0%

2020 30,541,978 2.0%Source: Texas Demographic Center at UT San Antonio. Population Migration

Growth Scenario 2000-2010.

II — Population


Source: Texas Demographic Center at UT San Antonio. Population Migration Growth Scenario 2000-2010.

Year

Rac

e / E

thni

city

Whi

teB

lack

His

pani

cO

ther

Tota

l

2010

11,3

97,3

452,

886,

825

9,46

0,92

11,

400,

470

25,1

45,5

61

2011

11,4

56,0

142,

942,

671

9,76

6,41

11,

466,

599

25,6

31,6

95

2012

11,5

13,5

702,

999,

289

10,0

81,4

881,

535,

700

26,1

30,0

47

2013

11,5

69,9

373,

056,

518

10,4

06,0

701,

607,

640

26,6

40,1

65

2014

11,6

24,8

813,

114,

187

10,7

40,4

561,

682,

418

27,1

61,9

42

2015

11,6

78,1

763,

172,

262

11,0

84,7

631,

760,

083

27,6

95,2

84

2016

11,7

29,6

183,

230,

618

11,4

39,4

021,

840,

607

28,2

40,2

45

2017

11,7

79,1

323,

289,

228

11,8

04,7

951,

924,

135

28,7

97,2

90

2018

11,8

26,4

703,

348,

098

12,1

81,1

672,

010,

744

29,3

66,4

79

2019

11,8

71,5

403,

407,

148

12,5

68,9

142,

100,

489

29,9

48,0

91

2020

11,9

14,0

453,

466,

308

12,9

68,0

262,

193,

599

30,5

41,9

78

II — Population

C. Texas Population, 2010-2020, By Year, By Race/Ethnicity


Year

Age

Gro

up

0 -

1718

- 29

30 -

4445

- 54

55 -

6465

+To

tal

2010

6,8

65,8

24

4,4

26,0

08

5,2

18,8

16

3,4

35,3

36

2,5

97,6

91

2,6

01,8

86

25,

145,

561

2011

6,9

44,7

58

4,4

96,1

37

5,3

20,3

69

3,4

61,6

04

2,7

23,5

51

2,6

85,2

76

25,

631,

695

2012

7,0

29,7

68

4,5

68,5

79

5,4

29,3

69

3,4

76,0

80

2,8

08,2

72

2,8

17,9

79

26,

130,

047

2013

7,1

21,4

99

4,6

36,8

54

5,5

41,8

88

3,4

87,2

41

2,8

98,0

69

2,9

54,6

14

26,

640,

165

2014

7,2

16,1

32

4,7

18,2

75

5,6

40,7

82

3,5

09,8

37

2,9

90,5

60

3,0

86,3

56

27,

161,

942

2015

7,3

11,9

23

4,7

98,4

12

5,7

25,1

41

3,5

42,2

91

3,0

91,9

03

3,2

25,6

14

27,

695,

284

2016

7,4

07,6

36

4,8

85,8

49

5,8

05,5

51

3,5

85,5

20

3,1

90,4

52

3,3

65,2

37

28,

240,

245

2017

7,5

00,2

72

4,9

87,4

09

5,8

95,1

84

3,6

24,7

41

3,2

77,4

41

3,5

12,2

43

28,

797,

290

2018

7,5

83,8

16

5,1

07,5

67

5,9

95,1

35

3,6

52,7

04

3,3

56,0

74

3,6

71,1

83

29,

366,

479

2019

7,6

64,5

55

5,2

36,1

51

6,1

07,9

77

3,6

77,7

43

3,4

26,3

05

3,8

35,3

60

29,

948,

091

2020

7,7

53,8

83

5,3

52,2

28

6,2

24,5

04

3,7

16,0

43

3,4

81,2

37

4,0

14,0

83

30,

541,

978

II — Population

D. Texas Population, 2010-2020, By Year, By Age Group



Year Texas Population Percent Change

2010 25,145,561 -

2020 30,541,978 21.5%

2030 37,155,084 21.7%

2040 44,955,896 21.0%

2050 54,369,297 20.9%

E. Texas Population, 2010-2050, By DecadeYe

arR

ace

/ Eth

nici

ty

Whi

teB

lack

His

pani

cO

ther

Tota

l

2010

11,3

97,3

452,

886,

825

9,46

0,92

11,

400,

470

25,1

45,5

61

2020

11,9

14,0

453,

466,

308

12,9

68,0

262,

193,

599

30,5

41,9

78

2030

12,1

76,4

014,

055,

033

17,5

75,6

563,

347,

994

37,1

55,0

84

2040

12,1

43,6

264,

599,

532

23,1

56,9

685,

055,

770

44,9

55,8

96

2050

11,9

54,6

155,

097,

826

29,8

59,0

127,

457,

844

54,3

69,2

97



II — Population

F. Texas Population, 2010-2050, By Decade, By Race/Ethnicity

1. Texas Population Projections, By Decade, By Race/Ethnicity, 2010-2050


II — Population

2. Texas Population Projections, Proportion of State Population By Race/Ethnicity, 2010-2050


F. Texas Population, 2010-2050, By Decade, By Race/Ethnicity

Wh

ite

Bla

ck

His

pa

nic

Oth

er

0%

10

%

20

%

30

%

40

%

50

%

60

%

20

10

20

15

20

20

20

25

20

30

20

35

20

40

20

45

20

50


1. Texas Population Projections, By Decade, By Age Group, 2010-2050


Year

Age

Gro

up

0 -

1718

- 29

30 -

4445

- 54

55 -

6465

+To

tal

2010

6,8

65,8

24

4,4

26,0

08

5,2

18,8

16

3,4

35,3

36

2,5

97,6

91

2,6

01,8

86

25,

145,

561

2020

7,7

53,8

83

5,3

52,2

28

6,2

24,5

04

3,7

16,0

43

3,4

81,2

37

4,0

14,0

83

30,

541,

978

2030

8,9

39,6

15

6,3

48,9

89

7,6

34,7

56

4,4

69,5

10

3,8

32,7

43

5,9

29,4

71

37,

155,

084

2040

10,

538,

300

7,1

47,5

79

9,5

48,5

41

5,4

73,3

74

4,6

64,7

17

7,5

83,3

85

44,

955,

896

2050

12,

327,

957

8,7

04,5

73

11,

073,

067

7,0

55,1

00

5,7

65,7

35

9,4

42,8

65

54,

369,

297

II — Population

G. Texas Population, 2010-2050, By Decade, By Age Group


2. Texas Population Projections, Proportion of State Population by Age Group, 2010-2050

II — Population


G. Texas Population, 2010-2050, By Decade, By Age Group

0-1

7

18

-29

30

-44

45

-54

55

-64

65

+

0%

5%

10

%

15

%

20

%

25

%

30

%

20

10

20

15

20

20

20

25

20

30

20

35

20

40

20

45

20

50


H. Fifteen Most Populous Texas Counties, By Rank, 2015

Source: Texas Demographic Center at UT San Antonio. Texas Population Estimates Program 2015.

II — Population

Rank County Population Estimate

Percent of State

Population1 Harris 4,530,268 16%

2 Dallas 2,541,528 9%

3 Tarrant 1,960,741 7%

4 Bexar 1,890,984 7%

5 Travis 1,169,907 4%

6 Collin 923,201 3%

7 Hidalgo 841,667 3%

8 El Paso 837,353 3%

9 Denton 778,846 3%

10 Fort Bend 716,491 3%

11 Montgomery 539,335 2%

12 Williamson 495,652 2%

13 Cameron 424,133 2%

14 Nueces 360,168 1%

15 Brazoria 345,717 1%


II — Population

I. Fifteen Least Populous Texas Counties, By Rank, 2015

Rank County Population Estimate

1 Loving 81

2 King 294

3 Kenedy 415

4 Borden 674

5 Kent 803

6 McMullen 861

7 Terrell 889

8 Roberts 926

9 Motley 1,104

10 Foard 1,213

11 Sterling 1,304

12 Glasscock 1,333

13 Stonewall 1,411

14 Cottle 1,423

15 Briscoe 1,476



II — Population

J. Ten Most Populous States, By State, Rank, Total Population, And

Race/Ethnicity, July 1, 2015

Stat

eTo

tal

Popu

lati

onR

ank

Tota

l Po

pula

tion

Rac

e / E

thni

city

Whi

teB

lack

His

pani

cO

ther

US

Tota

l32

1,41

8,82

061

.6%

12.4

%17

.6%

8.4%

Cal

iforn

ia1

39,1

44,8

1838

.0%

5.7%

38.8

%17

.5%

Texa

s2

27,4

69,1

1443

.0%

11.8

%38

.8%

6.4%

Flor

ida

320

,271

,272

55.3

%15

.6%

24.5

%4.

7%

New

York

419

,795

,791

56.0

%14

.6%

18.8

%10

.6%

Illin

ois

512

,859

,995

61.9

%14

.1%

16.9

%7.

1%

Penn

sylv

ania

612

,802

,503

77.4

%10

.7%

6.8%

5.1%

Ohi

o7

11,6

13,4

2379

.8%

12.4

%3.

6%4.

3%

Geo

rgia

810

,214

,860

53.9

%30

.9%

9.4%

5.9%

Nor

th C

arol

ina

910

,042

,802

63.8

%21

.4%

9.1%

5.7%

Mic

higa

n10

9,92

2,57

675

.6%

13.9

%4.

9%5.

6%

Source: US Census Bureau. Population Division, Population Estimates. July 1, 2015.


Source: IHS Global Insight: U.S Regional Service. December 2016 States’ Core Data Long Term Forecast.

K. Top Ten States By Change in Total Population Projection, By State, Rank, And Population 65 And Older,

2010-2040

Stat

e20

10-2

040

Cha

nge

in t

otal

pop

ulat

ion

2010

-204

0 C

hang

e in

age

65

and

olde

r

Num

ber

Perc

ent

Ran

k N

umbe

rPe

rcen

tR

ank

US

Tota

l 7

1,06

6,31

9 22

.8%

- 3

4,27

0,93

5 80

.6%

-

Uta

h 1

,796

,186

64

.6%

1 4

58,8

24

181.

9%1

Ari

zona

3,6

85,3

84

57.4

%2

989

,203

11

0.7%

7

Texa

s 1

3,83

6,27

1 54

.7%

3 3

,641

,506

13

8.3%

4

Flor

ida

8,7

66,3

84

46.4

%4

2,8

82,9

38

87.6

%21

Col

orad

o 2

,342

,277

46

.3%

5 7

87,7

17

141.

3%3

Nev

ada

1,2

35,7

62

45.7

%6

384

,697

11

7.0%

6

Idah

o 6

70,1

71

42.6

%7

232

,839

11

8.2%

5

Geo

rgia

3,8

42,4

78

39.5

%8

1,0

61,8

35

101.

6%10

Nor

th C

arol

ina

3,3

15,8

46

34.6

%9

1,1

79,4

39

94.6

%14

Sout

h C

arol

ina

1,4

65,2

47

31.6

%10

701

,540

10

9.7%

8

II — Population


L. Texans By Poverty Income Status, By Race/Ethnicity, Age and Citizenship Status, 2015

Dem

ogra

phic

C

ateg

ory

PO

VE

RTY

Tota

lR

ate

Inco

me

Bel

owA

bove

Rac

e /

Eth

nici

ty

Whi

te8.

6%99

3,33

410

,543

,552

11,5

36,8

86

Blac

k21

.2%

654,

644

2,42

8,71

63,

083,

360

Hisp

anic

22.6

%2,

371,

751

8,10

8,46

010

,480

,211

Oth

er12

.1%

210,

072

1,53

3,25

51,

743,

327

Age

G

roup

Und

er A

ge 1

822

.7%

1,61

3,80

85,

499,

921

7,11

3,72

9

Ages

18

- 64

13.8

%2,

298,

381

14,2

97,9

5916

,596

,340

Age

65+

10.1

%31

7,61

22,

816,

103

3,13

3,71

5

US

Cit

izen

ship

Stat

us

Nat

ive U

S Ci

tizen

14.9

%3,

317,

704

18,9

59,1

9122

,276

,895

Nat

ural

ized

US

Citiz

en11

.0%

181,

932

1,46

8,74

41,

650,

676

Not

a U

S Ci

tizen

25.0

%73

0,16

52,

186,

048

2,91

6,21

3

Texa

s Tot

al15

.8%

4,22

9,80

122

,613

,983

26,8

43,7

84

Note: Totals may not add up due to rounding. Based on the population for whom the percent of poverty income status was determined.

Source: US Census Bureau, 2015 American Community Survey (ACS) 1-Year Public Use Microdata Sample.

II — Population


M. Health Insurance1. Health Insurance Coverage Trends In The US And

Texas: 2011-2015

Year

ALL

AG

ES

Popu

lati

on

Wit

hout

Hea

lth

Insu

ranc

eU

ND

ER

18

Popu

lati

on

Wit

hout

Hea

lth

Insu

ranc

e

Num

ber

Perc

ent

Num

ber

Perc

ent

US

2011

46,3

75,5

3915

.1%

5,52

7,65

77.

5%

2012

45,6

14,5

4714

.8%

5,26

3,80

77.

2%

2013

45,1

80,6

7514

.5%

5,23

4,33

27.

1%

2014

36,6

70,2

2311

.7%

4,39

6,53

66.

0%

2015

29,7

57,5

449.

4%3,

533,

985

4.8%

Texa

s

2011

5,79

6,56

723

.0%

923,

923

13.3

%

2012

5,73

1,90

022

.4%

856,

272

12.3

%

2013

5,71

1,13

922

.0%

879,

498

12.5

%

2014

5,04

2,39

919

.0%

792,

048

11.2

%

2015

4,58

5,92

717

.0%

673,

153

9.4%

II — Population

Note: Totals may not add up due to rounding. Based on the civilian non-institutionalized population.

Source: US - US Census Bureau, 2011-2015 American Community Survey 1-Year Estimates; Texas - US Census Bureau, 2011-2015 American Community Survey (ACS) 1-Year Public Use Microdata Sample.


II — Population

2. Texans’ Health Insurance Coverage, By Race/Ethnicity, Age Group And Citizenship Status, 2015

Dem

ogra

phic

Cat

egor

yW

ith

Insu

ranc

eW

itho

ut In

sura

nce

Tota

lN

umbe

rPe

rcen

t

Rac

e/E

thni

city

Whi

te

10,5

21,8

011,

076,

250

9.3%

11,5

98,0

51

Blac

k2,

659,

484

455,

074

14.6

%3,

114,

558

Hisp

anic

7,68

0,06

12,

847,

559

27.0

%10

,527

,620

Oth

er1,

546,

501

207,

044

11.8

%1,

753,

545

Age

G

roup

Und

er A

ge 1

86,

518,

336

673,

153

9.4%

7,19

1,48

9

Ages

18

- 64

12,8

15,4

393,

853,

131

23.1

%16

,668

,570

Age

65+

3,07

4,07

259

,643

1.9%

3,13

3,71

5

US

Cit

izen

ship

Stat

us

Nat

ive U

S Ci

tizen

19,5

56,8

052,

858,

801

12.8

%22

,415

,606

Nat

ural

ized

US

Citiz

en1,

385,

390

265,

174

16.1

%1,

650,

564

Not

a U

S Ci

tizen

1,46

5,65

21,

461,

952

49.9

%2,

927,

604

Texa

s Tot

al22

,407

,847

4,58

5,92

717

.0%

26,9

93,7

74



M. Health Insurance


II — Population

3. Texans’ Health Insurance Coverage In 2015, By Percent Of Poverty Income Category

M. Health Insurance

Note: Totals may not add up due to rounding. Based on the civilian non-institutionalized population for whom the

percent of poverty income status was determined.


Dem

ogra

phic

C

ateg

ory

Wit

h In

sura

nce

Wit

hout

Insu

ranc

eTo

tal

Num

ber

Perc

ent

Perc

ent

of

Pove

rty

Inco

me

Cat

egor

y

100%

2,97

0,36

11,

257,

773

29.7

%4,

228,

134

133%

4,35

7,21

31,

789,

467

29.1

%6,

146,

680

185%

6,41

3,26

52,

508,

206

28.1

%8,

921,

471

200%

6,98

5,10

32,

693,

480

27.8

%9,

678,

583

200%

or

Hig

her

15,2

32,0

621,

866,

809

10.9

%17

,098

,871

Texa

s Tot

al22

,217

,165

4,56

0,28

917

.0%

26,7

77,4

54


4. Texans’ Health Insurance Coverage In 2015, By Educational Attainment And For Children By Family Type

II — PopulationD

emog

raph

ic

Cat

egor

yW

ith

Insu

ranc

e

Wit

hout

Insu

ranc

eTo

tal

Num

ber

Perc

ent

Edu

cati

onal

Att

ainm

ent

(For

per

sons

18

and

old

er)

Less

than

Hig

h Sc

hool

2,08

8,85

51,

295,

654

38.3

%3,

384,

509

Hig

h Sc

hool

3,87

0,30

91,

309,

270

25.3

%5,

179,

579

Som

e Co

llege

or A

ssoc

iate

Deg

ree

5,12

7,72

499

8,84

616

.3%

6,12

6,57

0

Colle

ge o

r Hig

her

4,80

2,62

330

9,00

46.

0%5,

111,

627

Tota

l15

,889

,511

3,91

2,77

419

.8%

19,8

02,2

85

Chi

ldre

n B

y Fa

mily

Typ

e

(Dep

ende

nt c

hild

ren

unde

r 18;

app

lies

only

to c

hild

ren

for w

hom

po

verty

inco

me

stat

us

was

det

erm

ined

)

In H

usba

nd-W

ife F

amily

4,30

8,61

144

5,00

09.

4%4,

753,

611

In S

ingl

e Pa

rent

Fam

ily2,

131,

404

218,

329

9.3%

2,34

9,73

3

Tota

l6,

440,

015

663,

329

9.3%

7,10

3,34

4



M. Health Insurance


— Notes —


III — ProgramsREGIONAL CHARACTERISTICSA. Map Of The Eleven Texas HHS Regions ..................................................26

B. Selected Texas Population Projections And Medicaid / CHIP Data ......................................27

FEDERAL POVERTY LEVEL AND INCOME LIMITS

C. 2016 Federal Poverty Levels (FPL) & FPL Limits For Selected Texas HHS

Programs .............................................................29

MEDICAID AND CHIPD. Estimated Number Of Children Eligible For

Medicaid Or CHIP, Number Of Children Enrolled, And The Estimated Number Of Eligible Children Who Remain Unenrolled,

SFYs 2015-2019 .................................................31

E. Medicaid and CHIP Caseloads .........................32


III — ProgramsTANFF. Temporary Assistance For Needy Families (TANF) .................................................34

SNAPG. Average Monthly SNAP Cases, Recipients

And Payments, By State Fiscal Year (SFY), SFYs 2009-2015 .................................................36

H. Percentage Breakdown of SNAP Recipients, By Age, By State Fiscal Year (SFY), SFYs 2009-2015 .................................................37

I. Changes in Client Services Populations: Impact of Managed Care Expansion Items,

State Fiscal Years (SFY), 2014-2019 ..............38

ExPENDITURESJ. Medicaid Expenditures.......................................40

K. CHIP Expenditures, Federal, Non-Federal And Total, By Year, Federal Fiscal Years (FFY)

2000-2017 ...........................................................43

L. Recipients And Expenditures ......................44

M. History Of Texas Medicaid Percentage Match ...................................................................49


1

2 3 4

5

6

7

8

910

11

A. Map Of The Eleven Texas HHS Regions

III — Programs

HHS Regions

1 — High Plains

2 — Northwest Texas

3 — Metroplex

4 — Upper East Texas

5 — Southeast Texas

6 — Gulf Coast

7 — Central Texas

8 — Upper South Texas

9 — West Texas

10 — Upper Rio Grande

11 — Lower South Texas


1. 2015 Texas Population Estimates And Under 19 Population Estimates, By HHS Region

III — Programs

B. Selected Texas Population Projections And Medicaid / CHIP Data

HHS Region

Percent Of Texas

Population

Percent Of Texas

Under 19 Population

1 - High Plains 3.2% 3.2%

2 - Northwest Texas 2.0% 1.8%

3 - Metroplex 26.9% 27.1%

4 - Upper East Texas 4.2% 3.7%

5 - Southeast Texas 2.8% 2.6%

6 - Gulf Coast 24.8% 24.8%

7 - Central Texas 12.0% 11.5%

8 - Upper South Texas 10.4% 10.2%

9 - West Texas 2.3% 2.3%

10 - Upper Rio Grande 3.1% 3.4%

11 - Lower South Texas 8.2% 9.4%

Texas Population Totals 27,469,114 8,048,884

Note: Totals may not add up due to rounding.



2. 2015 Texas Medicaid / CHIP Enrollment And Percent Of Texas Population Receiving Medicaid

& CHIP, By HHS Region

III — Programs

Notes: 1 Excludes CHIP Perinatal Program.

Total Texas Medicaid and CHIP Enrollment reported here may be lower than reported elsewhere because individuals with program type codes for specified low-income Medicare benefits (SLMB), qualified Medicare beneficiary (QMB), undocumented alien with emergency care only, and Healthy Texas Women were omitted since these programs do not provide full Medicaid benefits.

Totals may not add up due to rounding. Source: Texas Medicaid Program. 8-month Enrollment History File: CY 2015.

US Census Bureau, 2013-2015 American Community Survey (ACS) for Texas. CHIP Monthly Enrollment CY 2015.

HHS Region

Percent Of Total Medicaid & CHIP

Enrollment

Percent Of HHS Region Population Receiving

Medicaid & CHIP

1 - High Plains 3.1% 15.9%

2 - Northwest Texas 2.0% 15.6%

3 - Metroplex 23.8% 15.2%

4 - Upper East Texas 4.4% 17.1%

5 - Southeast Texas 3.1% 17.5%

6 - Gulf Coast 23.6% 16.7%

7 - Central Texas 9.2% 13.4%

8 - Upper South Texas 10.9% 18.1%

9 - West Texas 2.0% 15.0%

10 - Upper Rio Grande 4.3% 22.3%

11 - Lower South Texas 13.7% 28.1%

Total Texas Medicaid & CHIP1 Enrollment

4,394,501

B. Selected Texas Population Projections And Medicaid / CHIP Data


III — Programs

1. Percent Of Federal Poverty Levels, 2016

C. 2016 Federal Poverty Levels (FPL) & FPL Limits For Selected Texas HHS Programs

Fam

ily

Size

11%

16%

74%

100%

133%

144%

185%

198%

201%

220%

1$1

,295

$1

,883

$

8,71

0 $

11,8

80

$15,

800

$17,

107

$21,

978

$23,

522

$23,

879

$26,

136

2$1

,752

$2

,549

$

11,7

88

$16

,020

$2

1,30

7 $2

3,06

9 $2

9,63

7 $3

1,72

0 $3

2,20

0 $3

5,24

4

3$2

,210

$3

,214

$

14,8

67

$20

,160

$2

6,81

3 $2

9,03

0 $3

7,29

6 $3

9,91

7 $4

0,52

2 $4

4,35

2

4 $

2,66

8 $

3,88

0 $

17,9

45

$24

,300

$

32,3

19

$34

,992

$

44,9

55

$48

,114

$

48,8

43

$53

,460

5$3

,125

$4

,546

$

21,0

23

$28

,440

$3

7,82

5 $4

0,95

4 $5

2,61

4 $5

6,31

1 $5

7,16

4 $6

2,56

8

6$3

,583

$5

,211

$

24,1

02

$32

,580

$4

3,33

1 $4

6,91

5 $6

0,27

3 $6

4,50

8 $6

5,48

6 $7

1,67

6

7$4

,040

$5

,877

$

27,1

80

$36

,730

$4

8,85

1 $5

2,89

1 $6

7,95

1 $7

2,72

5 $7

3,82

7 $8

0,80

6

8$4

,498

$6

,542

$

30,2

59

$40

,890

$5

4,38

4 $5

8,88

2 $7

5,64

7 $8

0,96

2 $8

2,18

9 $8

9,95

8

Source: Federal Register; Vol. 81, No. 15. January 25, 2016, pp. 4036-4037.


III — Programs

C. 2016 Federal Poverty Levels (FPL) & FPL Limits For Selected Texas HHS Programs

Percent of FPL Program Eligibility Groups

11% Parent with two TANF children (monthly income limit is $188)

16% Medicaid Medically Needy Program(for family of 3, monthly income limit is $275)

17% TANF child (for family of 3, maximum grant is $286 per month)

74% Medicaid SSI (excluding Long-Term Care disabled)

130%Supplemental Nutrition Assistance Program(SNAP)

133%1 Medicaid children ages 6-18

144%1 Medicaid children ages 1-5 (excluding Long-Term Care disabled)

185% WIC program

198%1 Medicaid infants under age 1, pregnant women

201%1 CHIP

220% Medicaid Long-Term Care

2. Poverty Income Limits Associated With Selected HHS Programs

Notes: 1 Affordable Care Act modified adjusted gross income (MAGI) group standard.

Source: Center for Analytics and Decision Support, Texas Health and Human Services Commission.


III — Programs

D. Estimated Number Of Children Eligible For Medicaid Or CHIP, Number Of Children Enrolled, And The Estimated Number Of Eligible Children Who Remain Unenrolled, SFYs 2015-2019

SFY

Estimated Unduplicated

Yearly Enrollment

Average Monthly

Enrollment1

Estimated Number

of Eligible Children

Who Remain

Unenrolled

Enroll-ment Rate

Children's Medicaid2015 3,653,000 2,962,139 590,000 83%

2016 3,730,000 2,971,621 665,000 82%

2017 3,784,000 3,013,815 696,000 81%

2018 3,838,000 3,057,508 723,000 81%

2019 3,919,000 3,121,417 728,000 81%

CHIP2015 626,000 339,831 106,000 76%

2016 619,000 360,788 94,000 79%

2017 647,000 387,314 83,000 82%

2018 682,000 407,952 102,000 80%

2019 715,000 427,793 107,000 80%

Children's Medicaid & CHIP2015 4,279,000 3,301,971 696,000 83%

2016 4,349,000 3,332,409 759,000 81%

2017 4,431,000 3,401,129 779,000 81%

2018 4,520,000 3,465,460 825,000 81%

2019 4,634,000 3,549,211 835,000 81%

Notes: Estimates account for citizenship and income status of population (insurance status is also considered for CHIP). However, these estimates do not account for other factors considered during eligibility determination, such as resources.

1 Average Monthly Enrollment from November 2016 Forecast Update. Sources: US Census Bureau, 2013-2015 American Community Survey (ACS) for

Texas.


Note: 1 SFY 2016-2019 caseload values are forecast and subject to change.

Source: November 2016 Forecast Update, System Forecasting, Texas Health and Human Services Commission.

1. Medicaid Aged, Disabled, Poverty-Level Adults, Pregnant Women, Non-Disabled Children, And Total Medicaid, SFYs 2011-2019

E. Medicaid And CHIP Caseloads1

III — Programs

SFY

Age

d an

d M

edic

are

Rel

ated

Dis

abili

ty

Rel

ated

Pove

rty-

Leve

l Pa

rent

s/A

dult

s

Pre

gnan

t W

omen

Chi

ldre

n 0-

18, N

on-

Dis

abili

ty

Rel

ated

Tota

l M

edic

aid

2011

356

,656

3

90,8

19

104

,573

1

27,3

13

2,5

63,6

96

3,5

43,0

57

2012

363

,770

4

08,9

16

121

,358

1

26,3

14

2,6

35,5

71

3,6

55,9

30

2013

366

,748

4

20,3

27

127

,063

1

29,0

84

2,6

15,4

07

3,6

58,6

29

2014

372

,550

4

26,0

08

134

,662

1

36,8

11

2,6

76,6

58

3,7

46,6

89

2015

374

,105

4

26,9

73

152

,119

1

41,3

66

2,9

62,1

39

4,0

56,7

02

2016

1 3

74,0

58

427

,424

1

47,2

48

140

,403

2

,971

,621

4

,060

,753

2017

1 3

77,0

51

422

,966

1

49,8

42

142

,957

3

,013

,815

4

,106

,631

2018

1 3

81,5

72

428

,070

1

54,3

66

142

,053

3

,057

,508

4

,163

,570

2019

1 3

87,2

90

434

,306

1

58,1

29

143

,645

3

,121

,417

4

,244

,788


SFYMedicaid Children’s

Risk Groups

CHIP Caseload

CHIP CHIP Perinatal

TOTAL CHIP

2013 2,615,407 593,619 37,027 630,646

2014 2,676,658 524,658 36,825 561,483

2015 2,962,139 339,831 36,535 376,366

20161 2,971,621 360,788 35,069 395,857

20171 3,013,815 387,314 35,448 422,762

20181 3,057,508 407,952 35,461 443,412

20191 3,121,417 427,793 35,450 463,244

Note: CHIP Perinatal contains newborns < 185% FPL moving to Medicaid beginning SFY 2011. Traditional CHIP contains the Affordable Care Act (ACA) impact beginning Jan-14: moving caseload under 138% FPL to Medicaid. Medicaid Children contains ACA impacts beginning Jan-14: Eligible clients not enrolled, 12-month recertification impact, and CHIP under 133 FPL.

1 SFY 2016-2019 caseload values are forecast and subject to change.


2. Medicaid Children’s Risk Groups, CHIP, CHIP Perinatal, And Total CHIP, SFYs 2013-2019

III — Programs

E. Medicaid And CHIP Caseloads1


III — Programs

SFY

Cas

esR

ecip

ient

sC

hild

ren

Adu

lts

Paym

ents

Ave

rage

Pa

ymen

t

Per

Cas

e Pe

r R

ecip

ient

2013

37,5

57 8

9,72

4 7

7,52

2 1

2,20

2 $

6,39

0,76

2 $

170

$71

2014

32,5

85 7

7,40

3 6

7,49

5 9

,908

$5

,608

,917

$

172

$72

2015

28,1

70 6

7,26

9 5

9,19

7 8

,072

$

4,90

6,73

7 $

174

$73

2016

25,0

37 6

0,37

5 5

2,52

6 7

,849

$

4,46

0,31

3 $

178

$74

1. TANF BASIC Program — State Fiscal Year (SFY) Average Monthly: Cases, Recipients, Payments And Average Payments, SFYs 2013-2016

Notes: TANF Basic Program consists of cases which received a benefit in the reporting month. TANF Basic is the assistance program for qualifying child-only or single parent families funded with Federal dollars. A single case may contain multiple recipients.

Source: TANF Payment Files, Center for Analytics and Decision Support, Texas Health and Human Services Commission. 2013-16 update based on the October 2016 TANF Forecast for cases, recipients and payments. 2015-16 Children and Adult counts from TANF Annual Reports percentages.

F. Temporary Assistance For Needy Families (TANF)


2. TANF STATE Program — State Fiscal Year (SFY) Average Monthly: Cases, Recipients, Payments And Average Payments, SFYs 2013-2016

Notes: TANF State Program consists of cases which received a benefit in the reporting month. TANF State is the assistance program for qualifying 2-parent families funded with State dollars. A single case may contain multiple recipients.

Source: TANF Payment Files, Center for Analytics and Decision Support, Texas Health and Human Services Commission. 2013-16 update based on the October 2016 TANF Forecast for cases, recipients and payments. 2015-16 Children and Adult counts from TANF Annual Reports percentages.

III — Programs

SFY

Cas

esR

ecip

ient

sC

hild

ren

Adu

lts

Paym

ents

Ave

rage

Pa

ymen

t

Per

Cas

e Pe

r R

ecip

ient

2013

1,0

52

4,4

78

2,3

73

2,1

05

$31

0,32

9 $

295

$69

2014

916

3

,870

2

,038

1

,833

$

267,

127

$29

1 $

69

2015

1,1

71

4,2

64

2,5

58

1,7

06

$30

7,53

4 $

263

$72

2016

951

3

,399

2

,039

1

,360

$

252,

209

$26

5 $

74

F. Temporary Assistance For Needy Families (TANF)


III — Programs

Source: Monthly Texas Supplemental Nutrition Assistance Program (SNAP) Client Level Cutoff File, System Forecasting, Texas Health and Human Services Commission.

G. Average Monthly SNAP Cases, Recipients, Total Payments And Average Payment Per Case, By State Fiscal Year (SFY), SFYs 2009-2015

SFY

Num

ber

of C

ases

Num

ber

of

Rec

ipie

nts

Tota

l Pa

ymen

ts

Ave

rage

Pa

ymen

t Pe

r C

ase

2009

1,2

12,2

34

3,0

89,1

05

$35

2,97

2,47

2 $

291

2010

1,4

08,6

97

3,5

84,4

34

$43

5,37

6,08

4 $

309

2011

1,7

17,7

32

4,2

81,4

92

$48

1,84

7,14

5 $

281

2012

1,7

54,1

08

4,2

11,2

29

$50

2,18

3,01

3 $

286

2013

1,7

10,4

92

4,1

22,2

27

$49

4,81

9,04

2 $

289

2014

1,6

41,1

45

3,9

32,9

62

$44

6,69

0,07

3 $

272

2015

1,5

83,5

26

3,7

86,3

44

$436

,111

,442

$

275


Notes: These data are from a one-month snapshot, yet these proportions remain fairly stable over time. Totals may not add up due to rounding.

Source: Monthly Texas Supplemental Nutrition Assistance Program (SNAP) Client Level Cutoff File, System Forecasting, Texas Health and Human Services Commission.

III — ProgramsSF

YR

ecip

ient

s

Age

s <

5A

ges

5

- 17

Age

s 18

- 59

Age

s 60

- 64

Age

s 65

+

2009

20.0

%36

.4%

35.7

%1.

9%6.

0%

2010

19.4

%36

.2%

36.8

%2.

1%5.

6%

2011

19.1

%36

.3%

36.8

%2.

2%5.

6%

2012

18.5

%36

.4%

36.8

%2.

3%5.

9%

2013

17.9

%37

.0%

36.4

%2.

4%6.

3%

2014

17.4

%37

.5%

35.8

%2.

6%6.

7%

2015

17.1

%38

.1%

35.9

%2.

6%6.

3%

H. Percentage Breakdown of SNAP Recipients, By Age, By State Fiscal Year (SFY), SFYs 2009-2015


Note: 1 Expansion items include only those Managed Care (MC) expansions implemented on/before November 2016. Additional MC expansions are pending.

2 SFYs 2016-2019 are forecast and subject to change.


Program Type SFY 2014

SFY 2015

SFY 20162

FEE-FOR-SERVICE 734,427 532,121 490,327

% of total caseload 19.6% 13.1% 12.1%

MANAGED CARE 3,012,262 3,524,581 3,570,427


• HMO (STAR) 2,139,382 2,498,789 2,501,017


• STAR+Plus 410,999 538,385 536,673


• MRSA (STAR HMO) 431,149 442,544 455,290


• STAR Health 30,732 30,909 30,904


• Dual Demo - 13,954 46,542

% of total caseload - 0.3% 1.1%

• STAR Kids - - -

% of total caseload - - -

• Breast and Cervical Cancer Program - - -

% of total caseload - - -

TOTAL (FFS + MC) 3,746,689 4,056,702 4,060,753

III — Programs

I. Changes in Client Services Populations: Impact of Managed Care Expansion Items1, State Fiscal Years (SFY) 2014-20192


III — Programs

I. Changes in Client Services Populations: Impact of Managed Care Expansion Items1, State Fiscal Years (SFY) 2014-2019 (continued)2

Program Type SFY 20172

SFY 20182

SFY 20192

FEE-FOR-SERVICE 373,518 294,749 300,355


MANAGED CARE 3,733,113 3,868,821 3,944,433


• HMO (STAR) 2,526,216 2,607,923 2,662,389


• STAR+Plus 527,768 531,454 538,978


• MRSA (STAR HMO) 467,629 482,633 492,625


• STAR Health 32,011 32,479 32,808


• Dual Demo 42,116 42,201 42,802


• STAR Kids 137,372 167,442 170,111


• Breast and Cervical Cancer Program - 4,689 4,719

% of total caseload - 0.1% 0.1%

TOTAL (FFS + MC) 4,106,631 4,163,570 4,244,788

Note: 1 Expansion items include only those Managed Care (MC) expansions implemented on/before November 2016. Additional MC expansions are pending.

2 SFYs 2016-2019 are forecast and subject to change.



Note: Totals may not add up due to rounding.

Sources: CMS37 and CMS21B Quarterly Reports. 8/15/16, Financial Services, Texas Health and Human Services Commission.

1. Federal Fiscal Years (FFY) 1970-2017, Federal, Non-Federal And Total Expenditures, By Year

FFY Federal Non-Federal TOTAL

1970 $89.3 $47.6 $136.9

1975 $302.3 $173.0 $475.3

1980 $627.6 $435.8 $1,063.4

1985 $875.5 $713.6 $1,589.0

1990 $1,993.3 $1,262.8 $3,256.1

1995 $5,734.2 $3,363.2 $9,097.4

2000 $6,911.0 $4,380.1 $11,291.1

2001 $7,434.1 $4,863.6 $12,297.7

2002 $8,573.2 $5,696.4 $14,269.6

2003 $9,954.6 $6,246.8 $16,201.3

2004 $10,443.7 $6,360.6 $16,804.3

2005 $10,927.9 $7,024.7 $17,952.6

2006 $11,192.6 $7,410.8 $18,603.5

2007 $12,812.9 $8,563.6 $21,376.4

2008 $13,308.5 $9,000.7 $22,309.2

2009 $16,370.6 $8,186.3 $24,556.9

III — Programs

J. Medicaid Expenditures (in millions)


FFY Federal Non-Federal TOTAL

2010 $19,086.7 $8,563.8 $27,650.5

2011 $19,308.6 $10,124.8 $29,433.4

2012 $16,986.9 $12,361.3 $29,348.2

2013 $17,479.3 $12,054.2 $29,533.5

2014 $19,810.5 $13,584.0 $33,394.5

2015 $21,723.0 $15,246.7 $36,969.7

20161 $24,525.8 $18,047.2 $42,573.0

20171 $24,258.5 $18,353.5 $42,612.0

III — Programs

J. Medicaid Expenditures (in millions) 1. Federal Fiscal Years (FFY) 1970-2017, Federal, Non-

Federal And Total Expenditures, By Year (continued)

Notes: 1 Data for these years are estimates. Totals may not add up due to rounding.

Includes Disproportionate Share Hospital (DSH), Upper Payment Limit (UPL), Uncompensated Care (UC), and DSRIP Payments.

This report includes the increased Federal Funds from American Recovery and Reinvestment Act (ARRA) dollars through CMS. ARRA funds for client services ended with 3rd quarter 2011, but prior period expenditures continued to draw ARRA funds for eight quarters.

ARRA admin increase includes Health Information Technology (HIT) admin federal match which is still active.

Affordable Care Act (ACA) will have increased federal match for Balancing Improvement Program (BIP) which began 10/1/12 and ended 9/30/15.

Medicaid program expansions funded by CHIP (Title XXI) represent two populations - (1) From 1998 - 2003, CHIP Phase 1 was a short-term Medicaid Expansion implemented during the initial authorization of CHIP; and (2) Beginning 2011, Medicaid children who were Qualified Aliens were considered as a Medicaid Expansion. In January 2014, CHIP children under 138% FPL also moved to Medicaid as part of the Medicaid Expansion. These Medicaid Expansion children all are matched with Title XXI funds.

As of 8/15/2016, FFY1998-FFY2015 were updated with reported expenditure information from the CMS electronic system. The actual expenditure information includes prior year expenditures as reported each quarter.

Sources: CMS37 and CMS21B Quarterly Reports, 8/15/16, Financial Services, Texas Health and Human Services Commission.


Notes: * Data for these years are estimates. 1 Uncompensated Care (UC) funds replace UPL beginning September

2011. 2 The ‘Other’ category includes: Clawback, CHIP Title XXI (for FFYs

2011 - 2017), Administration, and Survey and Certification. As of 8/15/2016, FFY2006-FFY2015 were updated with reported

expenditure information from the CMS electronic system. The actual expenditure information includes prior year expenditures as reported each quarter.

Totals may not add up due to rounding.


2. Federal Fiscal Years (FFYs) 2006-2017, By Year

J. Medicaid Expenditures (in millions)FF

YG

rant

B

enefi

ts

Dis

prop

orti

onat

e Sh

are

Hos

pita

l P

rogr

am (D

SH)

Upp

er

Paym

ent

Lim

its

(UPL

)

Unc

omp-

ensa

ted

Car

e an

d D

SRIP

1O

ther

2T

OTA

L

2006

$15,

620

$1,5

43$5

27-

$914

$18,

604

2007

$16,

177

$1,4

38$2

,664

-$1

,098

$21,

376

2008

$17,

841

$1,4

59$1

,797

-$1

,212

$22,

309

2009

$19,

241

$1,7

46$2

,013

-$1

,557

$24,

557

2010

$21,

501

$1,6

88$3

,142

-$1

,320

$27,

651

2011

$23,

230

$1,5

79$3

,039

-$1

,586

$29,

433

2012

$23,

613

$1,5

16$2

,395

-$1

,825

$29,

348

2013

$23,

830

$227

-$3

,696

$1,7

81$2

9,53

4

2014

$25,

171

$1,5

26-

$4,6

88$2

,009

$33,

394

2015

$26,

540

$2,3

38-

$5,8

14$2

,278

$36,

970

2016

*$2

8,74

0$2

,536

-$8

,796

$2,4

99$4

2,57

1

2017

*$3

1,85

0$1

,853

-$6

,128

$2,7

82$4

2,61

3

III — Programs


K. CHIP Expenditures, Federal, Non-Federal And Total (in millions), By Year, Federal Fiscal Years (FFY) 2000-

2017FFY Federal Non-Federal TOTAL2000 $41.4 $15.4 $56.8

2001 $264.0 $100.6 $364.7

2002 $535.7 $207.1 $742.8

2003 $405.6 $157.9 $563.5

2004 $282.5 $109.0 $391.5

2005 $287.7 $108.5 $396.1

2006 $269.4 $102.4 $371.8

2007 $385.7 $145.9 $531.6

2008 $701.2 $267.5 $968.7

2009 $702.2 $279.2 $981.4

2010 $776.3 $315.4 $1,091.7

2011 $853.8 $325.8 $1,179.6

2012 $849.4 $351.3 $1,200.7

2013 $918.8 $366.2 $1,285.0

2014 $865.6 $352.3 $1,217.9

2015 $956.4 $397.7 $1,354.1

20161 $1,266.8 $95.5 $1,362.3

20171 $1,551.5 $128.9 $1,680.4

Notes: 1 Data for these years are estimates. Medicaid program expansions funded by CHIP (Title XXI) represent two

populations - (1) From 1998 - 2003, CHIP Phase 1 was a short-term Medicaid Expansion implemented during the initial authorization of CHIP; and (2) Beginning 2011, Medicaid children who were Qualified Aliens were considered as a Medicaid Expansion. In January 2014, CHIP children under 138% FPL also moved to Medicaid as part of the Medicaid Expansion. These Medicaid Expansion children all are matched with Title XXI funds. Expenditure information on this report includes Medicaid Expansion children. As of 10/1/15, CHIP had an enhanced match rate of 92.99% federal, which greatly decreased the Non-Federal portion of Federal Fiscal Year for FFY 2016. An additional 23% over standard EFMAP is expected to continue through FFY 2019.

As of 8/15/2016, FFY2000-FFY2015 were updated with reported expenditure information from the CMS electronic system. The actual expenditure information includes prior year expenditures as reported each quarter.

Totals may not add up due to rounding.


III — Programs


1. Texas Medicaid Expenditures By Service Type, State Fiscal Year 2015

Notes: Totals may not add up due to rounding.

Sources: Ad Hoc Query Platform Claims, CMS, Vendor Drug, Encounter Universes, TMHP, Center for Analytics and Decision Support Supplemental Payments Databases, System Forecasting, Texas Health and Human Services Commission.

Service Group Expenditure Percent

Physician and Professional $7,554,618,046 22%

Long-Term Services and Supports $7,193,559,762 21%

Hospital Inpatient $3,789,722,261 11%

Prescription Drugs $3,182,294,461 9%

Hospital and Clinic Out-Patient $3,133,375,181 9%

Dental $1,173,857,422 3%

Supplemental Payments $8,512,294,507 25%

Uncompensated Care and Delivery System Reform Incentive Payment (DSRIP)

$5,919,825,028 70%

Disproportionate Share Hospital (DSH) Program $1,722,499,027 20%

Delivery Supplemental Payments (DSP) $496,358,058 6%

Medicare Part D $373,612,394 4%

All Groups $34,539,721,640 100%

III — Programs

L. Recipients And Expenditures


Notes: Costs and caseload for all Medicaid payments for full beneficiaries and non-full beneficiaries (Women’s Health Waiver, Emergency Services for Non-Citizens, Medicare payments) are included.


2. Texas Medicaid Beneficiaries, By Recipient Group, State Fiscal Year 2015

III — Programs


3. Texas Medicaid Expenditures, By Recipient Group, State Fiscal Year 2015

24%

7%

69%

0% 10% 20% 30% 40% 50% 60% 70%

Aged & Disability-Related

Non-Disabled Adults

Non-Disabled Children

Caseload

59%

9%

32%

0% 10% 20% 30% 40% 50% 60% 70%

Aged & Disability-Related

Non-Disabled Adults

Non-Disabled Children

Cost


Ris

k G

roup

Ave

rage

Mon

thly

Acu

te C

are

Med

ical

and

Dru

g C

osts

2

FY 2

015

FY 2

0161

FY 2

0171

FY 2

0181

FY 2

0191

Dis

abili

ty-R

elat

ed $

1,14

7.48

$

1,19

8.85

$

1,23

0.29

$

1,28

9.97

$

1,35

5.01

Preg

nant

Wom

en $

721.

79

$74

9.86

$

765.

55

$77

6.56

$

794.

13

New

born

s $

669.

12

$67

0.09

$

691.

26

$69

6.83

$

719.

47

TAN

F Pa

rent

s $

453.

08

$44

6.10

$

468.

50

$49

1.42

$

517.

37

Ove

rall

Acu

te C

are

/ Dru

g C

ost

$34

6.08

$

353.

52

$35

8.00

$

369.

20

$38

4.26

Chi

ldre

n A

ges

1-18

, Non

-Dis

able

d $

196.

51

$19

8.47

$

200.

76

$20

5.33

$

214.

33

Age

d &

Med

icar

e R

elat

ed 3

$92

.19

$97

.95

$98

.17

$10

0.69

$

103.

73

Notes: 1 FY 2016-2019 are forecast and subject to change. 2 Costs are through November 2016 and include all Acute Care

services for Full-Benefit Medicaid clients, including Dental and Drug Costs.

3 Aged and Medicare Related Costs do not include costs paid for Part A and Part B Premiums for Full and Partial Dual Eligible Clients. Costs in the Aged and Medicare Related Risk Group include only those co-payments, deductibles, and drugs not covered through Medicare.

Source: Texas Health and Human Services Commission, Financial Services, System Forecasting, November 2016 Caseload/Cost Forecast, Full Client Forecast.

4. Average Monthly Acute Care Medical and Drug Costs, By Risk Group, Ranked by Per Member

Per Month (PMPM), SFYs 2015-20191


III — Programs


— Notes —


5. Top Ten States Ranked By Medicaid Expenditures, Total Population, Medicaid Enrollment, And Per Capita Medicaid Spending, 2015

L. Recipients And ExpendituresSt

ate

Tota

l M

edic

aid

Exp

endi

ture

s (in

billi

ons)

1

Popu

lati

on 2

Med

icai

d E

nrol

lmen

t 3

Per

Cap

ita

Med

icai

d

Ran

kN

umbe

rR

ank

Num

ber

Ran

kA

mou

nt

Cal

iforn

ia $

85.5

1

39,1

44,8

181

12,

648,

637

7 $

2,18

5

New

York

$59

.8

419

,795

,791

2 6

,512

,137

1

$3,

021

Texa

s $

35.8

2

27,4

69,1

143

4,6

78,3

94

34 $

1,30

4

Penn

sylv

ania

$23

.4

612

,802

,503

7 2

,665

,455

17

$1,

827

Ohi

o $

21.6

7

11,6

13,4

236

2,9

88,9

34

15 $

1,86

0

Flor

ida

$21

.5

320

,271

,272

4 3

,558

,092

42

$1,

059

Illin

ois

$17

.0

512

,859

,995

5 3

,162

,522

33

$1,

325

Mic

higa

n $

15.9

10

9,92

2,57

68

2,3

52,1

27

20 $

1,60

7

Mas

sach

uset

ts $

15.6

15

6,79

4,42

213

1,6

49,4

23

5 $

2,29

1

New

Jers

ey $

14.2

11

8,95

8,01

310

1,7

89,2

64

22 $

1,58

9

III — Programs


5. Top Ten States Ranked By Medicaid Expenditures, Total Population, Medicaid Enrollment, And Per Capita Medicaid Spending, 2015 (continued)

III — Programs

Not

es:

1 Med

icai

d Ex

pend

iture

s —

Dat

a ar

e fo

r FF

Y 2

015.

Med

icai

d ex

pend

iture

s do

not

incl

ude

adm

inis

trat

ive

cost

s, ac

coun

ting

adju

stm

ents

, or

the

U.S

. Ter

rito

ries

. Tot

al M

edic

aid

spen

ding

incl

udin

g th

ese

addi

tiona

l ite

ms

was

$55

2.0

billi

on in

FFY

201

5.

2 T

otal

Pop

ulat

ion

— A

s of

July

1, 2

015.

3 M

edic

aid

Enro

llmen

t —

Dat

a ar

e fo

r Ju

ly 2

015.

The

tot

al u

ndup

licat

ed n

umbe

r of

indi

vidu

als

enro

lled

in M

edic

aid

and

CH

IP a

s of

the

la

st d

ay o

f eac

h re

port

ing

peri

od, i

nclu

ding

tho

se w

ith r

etro

activ

e, c

ondi

tiona

l, an

d pr

esum

ptiv

e el

igib

ility

. Thi

s in

dica

tor

is a

poi

nt-in

-tim

e co

unt

of t

otal

pro

gram

enr

ollm

ent,

and

is n

ot s

olel

y a

coun

t of

tho

se n

ewly

enr

olle

d du

ring

the

rep

ortin

g pe

riod

. Thi

s nu

mbe

r in

clud

es o

nly

thos

e in

divi

dual

s w

ho a

re e

ligib

le fo

r co

mpr

ehen

sive

ben

efits

(e.

g., e

mer

genc

y M

edic

aid,

fam

ily p

lann

ing-

only

cov

erag

e an

d lim

ited

bene

fit d

ual e

ligib

le in

divi

dual

s ar

e ex

clud

ed).

Med

icai

d Se

ctio

n 11

15 d

emon

stra

tion

popu

latio

ns a

re in

clud

ed a

s lo

ng a

s th

e be

nefit

s an

d ne

twor

ks a

re c

ompr

ehen

sive

.

Sour

ces:

Med

icai

d Ex

pend

iture

s —

Dat

a ar

e fr

om T

he K

aise

r Fa

mily

Fou

ndat

ion

Stat

e H

ealth

Fac

ts. D

ata

Sour

ce: U

rban

Inst

itute

est

imat

es

base

d on

dat

a fr

om C

MS

(For

m 6

4) (

as o

f 9/1

/16)

.

To

tal P

opul

atio

n —

Ann

ual E

stim

ates

of t

he R

esid

ent

Popu

latio

n fo

r th

e U

nite

d St

ates

, Reg

ions

, Sta

tes,

and

Puer

to R

ico:

Apr

il 1,

201

0 to

July

1, 2

015

(NST

-EST

2015

-01)

, Pop

ulat

ion

Estim

ates

Pro

gram

, Pop

ulat

ion

Div

isio

n, U

.S. C

ensu

s Bu

reau

, Dec

embe

r 20

15.

M

edic

aid

Enro

llmen

t —

Dat

a ar

e fr

om T

he K

aise

r Fa

mily

Fou

ndat

ion

Stat

e H

ealth

Fac

ts. D

ata

Sour

ce: C

MS,

Med

icai

d &

CH

IP M

onth

ly

App

licat

ions

, Elig

ibili

ty D

eter

min

atio

ns, a

nd E

nrol

lmen

t R

epor

ts: F

ebru

ary

2014

- S

epte

mbe

r 20

16 (

prel

imin

ary)

, as

of D

ecem

ber

1,

2016

.



1. Federal Medical Assistance Percentages (FMAP), Enhanced Federal Medical Assistance Percentages (EFMAP), By State And Federal Percentages, By

State Fiscal Year and Federal Fiscal Year, 2009-2019.

M. History Of Texas Medicaid Percentage Match

Year Type

State Fiscal Year Federal Fiscal Year

State%

Federal%

State%

Federal %

2009FMAP 40.47 59.53 40.56 59.44

EFMAP 28.32 71.68 28.39 71.61

2010FMAP 41.21 58.79 41.27 58.73

EFMAP 28.85 71.15 28.89 71.11

2011FMAP 39.59 60.41 39.44 60.56

EFMAP 27.72 72.28 27.61 72.39

S T

I M

U L

U S

2009FMAP 31.74 68.26 30.97 69.03

EFMAP 28.32 71.68 28.39 71.61

2010FMAP 29.15 70.85 29.06 70.94

EFMAP 28.85 71.15 28.89 71.11

2011FMAP 32.68 67.33 33.54 66.46

EFMAP 27.72 72.28 27.61 72.39

2012FMAP 41.58 58.42 41.78 58.22

EFMAP 29.11 70.89 29.25 70.75

III — Programs

Notes: • As of January 2013. • EFMAP is the Enhanced Federal Medical Assistance Percentage (CHIP rate). • State Fiscal Year runs from September 1 to August 31. Federal Fiscal Year runs from October 1 to September 30. • Stimulus Assumptions are Tier I Oct 2008-June 2009, Tier II July 2009-Sept 2009, Tier III Oct 2009-Dec 2010. A phased-down 6 month extension from Jan-Jun 2011 is included for FY 2011 as stated in IB 10-33 (August 17, 2010). • State Fiscal Year stimulus rates are based on 11 months stimulus rate in SFY 2009, 12 months 2010 and 10 months 2011. • FFY 2010 rates are final, as stated in Federal Register Vol. 73, No. 229, November 26, 2008. (continued on next page)


Year TypeState Fiscal Year Federal Fiscal Year

State %

Federal %

State %

Federal %

2013FMAP 40.79 59.21 40.70 59.30

EFMAP 28.55 71.45 28.49 71.51

2014FMAP 41.26 58.74 41.31 58.69

EFMAP 28.88 71.12 28.92 71.08

2015FMAP 41.9 58.1 41.95 58.05

EFMAP 29.32 70.68 29.36 70.64

2016FMAP 42.79 57.21 42.87 57.13

EFMAP 29.96 70.04 30.01 69.99

2017FMAP 43.74 56.26 43.82 56.18

EFMAP 30.61 69.39 30.67 69.33

2018FMAP 43.18 56.82 43.12 56.88

EFMAP 30.22 69.78 30.18 69.82

2019FMAP 42.66 57.34 42.62 57.38

EFMAP 29.86 70.14 29.83 70.17

III — Programs

Notes: (continued from previous page) • FFY 2011 non-stimulus rates are final as stated in Federal Funds Information for States Issue (FFIS) Issue Brief 09-38, October 21, 2009. • FFY 2012 rates are final, as stated in Federal Register Vol. 75, No. 217, November 10, 2010. •FFY 2013 rates are final, as stated in Federal Register Vol. 76, No. 230, November 30, 2011.• FFY 2014 rates are final, as stated in Federal Register Vol. 77, no 231, November 30, 2012 • FFY 2015 rates are final, as stated in Federal Register Vol. 79, no. 13, January 21, 2014. FFY 2016 rates are final as stated in the FFIS Brief 14-32, October 1, 2014. FFY 2017 rates are final, as stated in Federal Register Vol. 80 no. 227, November 25, 2015. FFY 2018 rates are final, as stated in FFIS Issue Brief 16-49, September 29, 2016. Expenditures in Medicaid and CHIP paid with Title XXI funds will be eligible for an additional 23% point match between Oct 1, 2015 - Sept 30, 2019. FFY 2019 rates are estimated.

1. Federal Medical Assistance Percentages (FMAP), Enhanced Federal Medical Assistance Percentages (EFMAP), By State And Federal Percentages, By

State Fiscal Year and Federal Fiscal Year, 2009-2019 (continued)

M. History Of Texas Medicaid Percentage Match


— Notes —

Prepared by

Center for Analytics and Decision SupportPolicy and Performance Division

TexAs HeAlTH AnD HumAn serviCes COmmissiOn

— February 2017 —

Documents

2017 FACT BOOK - Texas Health and Human Services · 2017-02-10 · 4 2017 Texas HHS Fact Book I — Budget A. State Budget, State Fiscal Year (SFY) 2017 (in millions) Note: Figures