Medicaid program now serves 16,931 beneficiaries

Medicaid administrator Helen C. Sablan disclosed yesterday that the program now has a total of 16,931 clients since the beginning of the fiscal year on Oct. 1 and the number is expected to climb through the end of the 12-month period in September 2012.

She said the number of people enrolled in the program increases every year and she already expects a 5- to 10-percent rise in enrollment in fiscal year 2012.

This projection may change, however, depending on the impact of federalization on contract workers who have U.S. citizen children that are eligible for Medicaid benefits.

Sablan disclosed that her office had 14,700 clients in fiscal year 2010. This fiscal year, new customers now total 2,231, which represent a 15.1-percent increase.

Among the factors contributing to the rise in Medicaid members are the large number of newborns and changes in parents’ employment statuses. Another is the work-hour reduction being implemented in both the government and private sectors.

Sablan also cited the large number of families who dropped their health insurance due to high premium rates. “They dropped their health insurance because they just can’t afford it,” she said.

Hundreds of people dropping their health insurance has resulted in the dramatic increase of clients in many government programs such as Medicaid, Medicare, and medical referral.

About three years ago, the Medicaid program had only a little over 10,000 clients.

According to Sablan, the Medicaid program requires a specific threshold amount for poverty level. Clients are strictly U.S. citizens and mostly comprise employees who experienced cuts in work hours.

In the past, the program required a 50-50 sharing between local and federal governments, which meant that for every $1 spent, the CNMI had to find 50 cents as matching fund. However, because of President Barrack Obama’s Affordable Healthcare Act, the matching ratio was changed to 45-55 and will remain so until 2019.

Gov. Benigno R. Fitial earlier told Saipan Tribune that the government is having a hard time finding the matching funds for the Medicaid program.

Sablan said that the CNMI has no control over the number of Medicaid clients it serves.

“We can’t do that [put a cap] because it’s against federal law. We have bracket and criteria based on income and resources,” she explained.

She hopes, however, that Congress will reduce the local matching share for all territories and insular areas.

Sablan also said yesterday that Medicaid will soon have a total of five personnel—including herself—to work on the increasing number of applications and recurring backlogs. The program used to have only three staff.

She said that two trainees from the Workforce Investment Agency are being converted into permanent employees and they will assist the program’s lone eligibility worker and accounting staffer. All five will be paid using the program’s budget.

“Our biggest challenges: limited resources and staffing. We have only one eligibility worker working on all applications and processing. We’re really in a backlog, which is the reason why we only open during mornings so [Rose Benito] can process them in the afternoon,” she said.

Sablan said the program receives a maximum of 50 visits on a peak day. For the office to function efficiently, she said she may need two to three more personnel.