“I appreciate what Sablan is doing but what he really should be working on, in my opinion and I recommend this to him is to remove the cap and see to changing the ratio to 75-25 on Medicaid,” Babauta told media in an interview after the Chamber of Commerce membership meeting at the Fiesta Resort & Spa yesterday.
Babauta said that the federal government has put a $5million cap and the CNMI has to match it with another $5 million.
“The CNMI continue to certify more people which is above and beyond the $10 million fund, so after that it is all CNMI money and we cannot afford it, that’s why we need to remove the cap,” Babauta said.
He said that the CNMI and other US territories match the funding dollar for dollar, or 50 percent federal and 50 percent state fund but some areas like Mississippi, the ratio is lower.
“In Mississippi, they get their Medicaid reimbursement at a ratio of 75-25 percent, which means 75 cents for each dollar comes from the federal funds and 25 cents comes from the state funds,” he said.
“If that’s the kind of match that CNMI will have, we can actually breathe in terms of the cost of Medicaid that we are experiencing here, but this will have to come through federal legislation,” Babauta said.
He said that the Medicaid cap ratio now is 45-55, where 55 comes from the federal and the CNMI matches it with 45 because of the ARRA funding which is temporary but in the next year or two it will go back to the original 50-50 ratio.
“I’ve been urging the legislature to call for an oversight bringing all the parties concerned so we can understand where we are and change some of the policies to ease the burden of the Medicaid program,” Babauta said.
Babauta said that the CNMI cannot afford to pay for the Medicaid services of qualified eligible individuals which had bloated from 3,000 in 2004 to 18,000 in 2011.
“My concern is really a matter of policy and how many more do we need to certify as eligible. I understand that if people qualify, they have to be certified but we have to be realistic as to how much we can afford so at some point we have to come up with a policy,” he said.
He said that there is no way that the CNMI can pay for the services for 18,000 who are eligible for Medicaid.
“We should not be certifying any more people. We don’t want to mislead people and what is happening right now is that we are in financial difficulties, the economy is down and we are not generating enough revenue to pay for the services,” Babauta added.
He added that he wished the legislature can call in an open hearing where affected parties will come in so ‘everyone will know where they are and move in the same direction.’
Babauta said that when the CNMI Healthcare Corp came into effect, the law said that everything that was formerly under the Department of Health will have to come under the corporation but there was no mention of Medicaid.
“Nothing was said about Medicaid so I just assumed that Medicaid stays with the administration,” he said.
He added that the Corporation is still a part of the government because they still receive appropriations from the legislature like other government agencies.
“We are working on the transition of federal funds now because the way the financial system is set up, the corporation does not have the ability or infrastructure to do that right now,” Babauta said. He said that the finances of the corporation are currently processed by the Department of Finance for the time being.
