“I DON’T know how I’m going to find you $33 million,” Senate Committee on Fiscal Affairs Chair Victor B. Hocog told CNMI Medicaid Agency Acting Director Vicenta Borja during a budget hearing on Saipan last week.
Borja said the agency may need $33 million in local matching funds to avail itself of roughly $100 million in federal funds.
Through Section 1108 of the Social Security Act, each territory is considered a state for purposes of Medicaid and the Children’s Health Insurance Program, or CHIP, and are provided base funding to serve their Medicaid populations.
Because Medicaid still operates as an entitlement with benefits guaranteed to all eligible individuals who apply, territories historically have exceeded their annual Section 1108 allotments.
Over the past decade, the U.S. Congress has temporarily increased federal funding for the territories’ Medicaid programs via a number of specific statutory provisions.
“We can never know exactly what we need in the next fiscal year because our financials are always dependent on the U.S. Congress,” Borja said. “Right now, for FY ‘23, the amount that we’re looking for reimbursement matching is $33 million if U.S. Congress doesn’t extend our federal medical assistance percentage…. Today, we are at 10.8%, but that expires on Dec. 13. If there’s no action in Congress, starting Dec. 14, we will revert to the original Medicaid [rate] for which the local government will be responsible for 45%. That’s where the $33 million is for,” Borja added.
“We are certain that we are going to receive federal funding. We are not certain how much of the local matching we’re going to need because it’s dependent on the federal medical assistance percentage,” Borja said. “We cannot utilize our federal funding without [local] matching [funds],” she said.
“The federal funds that we’re going to receive for fiscal year 2023 are already a set amount. One of them alone is $65 million. We have COFA funding as well, which is $3 million. We have CHIP, which is about $28 million, and the [Enhanced Allotment Plan or EAP] is $265,000, so we’re looking at [over] $100 million in federal funds that all require local matching funds. The total local matching that we’re looking for is $33 million for fiscal year 2023 if the U.S. Congress does not extend the [federal matching assistance percentage or] FMAP…. If they extend it, then we maintain the 10.8%, so we’d only need about $7.2 million” in local matching funds, Borja said.
The Senate panel is anticipated to present its committee report on the FY 2023 budget bill to the full Senate body during a session at 10:30 a.m. Friday, Sept. 23, at the Tinian courthouse.
FY 2023 starts on Oct. 1, 2022. If there is no new balanced budget enacted into law before that date, there will be a partial government shutdown.
