Fitial, in an e-mail, said Congressman Gregorio C. Sablan missed the point in treating the increase in Medicaid funding as “significant win” for the CNMI.
Although the Affordable Care Act provides more Medicaid funding for the CNMI, Fitial said “it does nothing to significantly reduce the local match for the Medicaid program.”
Currently, he added, the CNMI must match 50 percent of every dollar up to an annual limit. The new U.S. law reduces the local match to 45 percent.
Fitial said this helps, but it doesn’t address the CNMI’s current fiscal situation.
Some states, he added, have been able to realize a reduction in match requirements which provides them with upwards of an 83 percent federal share.
“I know our current congressional delegate has touted the healthcare reform as a win for the CNMI, particularly the increase in Medicaid. While I believe that there are some good provisions in the ACA, the increase in Medicaid is not one that I particularly see as a benefit,” Fitial said.
“We have to assess the long term impacts and be cognizant that the increase in Medicaid also increases the amount of money that the CNMI has to bring to the table. This is money that we don’t have. The fact of the matter is that the delegate failed to look at the statute which establishes our local matching rate and further failed to make efforts to address this issue,” he added.
He said his administration has done everything to try and negotiate with the U.S. Department of Health and Human Services on a reduction in match. However, he added, this requires a legislative fix.
Asked for comment, Sablan said: “I have not seen this e-mail that is reported to have come from the governor. But, if it’s true, I am shocked. Because this is exactly the opposite of what the governor was saying last year, when I consulted with him on health care reform legislation.”
Sablan said Fitial wrote to the congressman on July 21, 2009 about this issue.
“This is what the governor said: ‘I believe that a total allocation of $150 million for Medicaid, over the ten year period covered by the bill, would allow us to provide satisfactory, quality coverage for all those in the Northern Marianas in need of this coverage.
“This amount will sufficiently provide for medical care for the coming decade based on current population and use. While increases are, of course always welcome, the amount specified would permit us to give those in need better access to care that would greatly improve their quality of life,” the governor added.
Now, Sablan said, “the governor is totally flip-flopping. He doesn’t seem to know what he wants or what is best for the commonwealth. But let me say: it’s always better to have $158 million than not to have $158 million.”
He added, “I would also very respectfully suggest that the governor should stop campaigning for delegate. The governor should be spending every minute of his day solving the shutdown problem, which is causing pain and suffering to thousands of people and their families.”
