THE House of Representatives supports U.S. Congressman Gregorio Kilili Camacho Sablan’s H.R. 265, which proposes to amend the Social Security Act to eliminate Medicaid funding limitations for U.S. territories including the CNMI.
If enacted into law, H.R. 265 or the Insular Area Medicaid Parity Act, which Kilili introduced in January, will exempt the CNMI, Puerto Rico, the U.S. Virgin Islands, Guam and American Samoa from Medicaid funding limitations as provided for in Section 1108 of the Social Security Act.
Last week, U.S. Congressman Michael San Nicolas of Guam and Guam Gov. Lou Leon Guerrero joined Kilili in calling for the passage of H.R. 265 during a U.S. House Energy and Commerce Subcommittee on Health hearing.
San Nicolas testified during the hearing while Leon Guerrero submitted her written testimony.
In a joint letter addressed to some members of the U.S. House leadership, Speaker Edmund Villagomez, Vice Speaker Blas Jonathan Attao, House Floor Leader Ralph Yumul, Reps. Tina Sablan, Donald Manglona and Vicente Camacho said they strongly support H.R. 265.
They said the citizens in the CNMI and millions of their fellow Americans in the U.S. insular areas “have faced chronic underfunding of Medicaid; and now an impending Medicaid ‘fiscal cliff’ jeopardizes access to critically needed health care.”
H.R. 265 will “correct the serious inequity by lifting the cap on general Medicaid funding to the territories that is set forth in Section 1108 of [the] Social Security Act,” the CNMI lawmakers said.
“The major disparity between Medicaid in the territories and Medicaid in the states is in the financial treatment, as highlighted in recent reports to Congress by the Medicaid and Children’s Health Insurance Program or CHIP Payment and Access Commission. Unlike the states, statutory annual ceilings apply to Medicaid funding in the territories regardless of changes in enrollment or services. The Section 1108 caps have resulted in historically insufficient resources to meet the health care needs of our Medicaid eligible citizens. Another statutory inequity lies in the Federal Medical Assistance Percentage (FMAP), or the matching rate, which for the territories is fixed at 55% federal to 45% non-federal share for most Medicaid expenses,” the CNMI lawmakers said.
They asked the U.S. Congress to apply to the territories the same FMAP formula used for the states and that takes into account the relative income and poverty levels of other U.S. jurisdictions.
“Eliminating the cap and applying an equitable method in determining the assistance percentage will enable the Medicaid programs in the CNMI and other territories to provide the same level of care that Medicaid-eligible citizens receive in the states, ensure that health care providers are reimbursed appropriately for the services delivered, and allow the territories to plan and manage the Medicaid programs as the states do,” the CNMI lawmakers said.
