Kilili: Permanent fix to Marianas Medicaid passes

Gregorio Kilili C. Sablan

WASHINGTON, D.C.—The federal government will permanently cover 83% of the cost of Medicaid in the Marianas under terms of the fiscal year 2023 spending deal passed by the U.S. Senate on Thursday and the House of Representatives on Friday. The bill now awaits President Joe Biden’s signature to become law.

The 83% federal share for Marianas Medicaid is the highest for any state or territory and has been in place on a temporary basis since 2019. Without the extension in Friday’s fiscal 2023 spending bill the federal share would drop to 55%, requiring the Commonwealth to spend an additional $40 million to completely draw down available federal funds.

“This is very good news for everyone in our islands and the result of many years of work,” said Delegate Gregorio Kilili C. Sablan (D-MP).

“I am especially grateful to Medicaid director Helen Sablan, who made such a strong case for increasing federal funding and lowering the local share of costs at the hearing on insular area Medicaid that I held in 2019.

“Her advocacy at the hearing and impeccable administration of the program in the Marianas helped pass U.S. Public Law 116-94 three years ago, raising funding to $60 million with an annual inflation adjuster. And Helen has continued to consult with congressional staff in the lead up to this week’s success.”

When Sablan first took office in 2009, the Commonwealth received just $5 million each year from the federal government for Medicaid and had to match that money dollar-for-dollar. Sablan was able to get $109 million funding for the Marianas and an improved matching rate in the 2010 Affordable Care Act, Obamacare. When those funds were used up, he added another $36 million for Marianas Medicaid with a floor amendment to the 2019 disaster bill, U.S. Public Law 116-20.

Then, with passage of P.L. 116-94 he raised the funding floor to $60 million with annual increases based on the medical care component of the consumer price index. By fiscal 2022 funding reached $64 million. Fiscal 2023 is expected to top $66 million for the Marianas.

Sablan also used P.L. 116-94 to lower the required local match. The Commonwealth’s share dropped from 45% to 17% with the federal government picking up the other 83%. But the change was only temporary, a problem Friday’s legislation fixes.

The Senate passed the Consolidated Appropriations Act, 2023 by a vote of 68-29. The House voted 225-201 for passage. The White House has already said that Biden will sign the legislation. (PR)