‘Medicaid funding issue did not arise during House budget talks

House Ways and Means chair Rep. Ivan A. Blanco (R-Saipan) said yesterday that they were not made aware of the Commonwealth Medicaid Agency’s funding concerns, which is why the issue never came up during their deliberation on the fiscal year 2021 budget bill.

When asked for comments about Medicaid’s concerns, Blanco said they worked off of Gov. Ralph DLG Torres’ budget proposal. “Had we received the Medicaid letter during Ways and Means deliberation, we would have addressed the issue,” he added.

Commonwealth Medicaid Agency director Helen C. Sablan reported a 32.7% increase in Medicaid beneficiaries in a six-month period from February to July 10, 2020, even as she expressed fear that the CNMI may lose millions of dollars in health care funding if the government fails to adequately fund the program.

In a letter dated Aug. 25, 2020, Sablan informed Fiscal Affairs Committee chair Sen. Jude U. Hofschneider (R-Tinian) that they have been working hard to ensure that the program complies with the requirements of Title IX and meets the expectations of the U.S. Congress and the Centers for Medicare and Medicaid Services.

Sablan said that the House proposed budget for the agency for fiscal year 2021 would result in a shortfall of $6.21 million, which would jeopardize the CNMI’s ability to receive millions of dollars in health care funding. She added that they do not believe that it is in the interest of the CNMI to lose such funding at a time when federal expenditures are one of the few sources of economic input.

Blanco said the House passed the fiscal year 2021 budget, which includes funding for Medicaid, as proposed by the Torres administration. “As the budget is still in the review process, we anticipate to work with Medicaid on its concerns as indicated in its letter,” Blanco said.

During Tuesday’s House session, Rep. Tina Sablan (D-Saipan) requested House Speaker Blas Jonathan Attao and Blanco to call the Commonwealth Medicaid Agency so they can address their concerns.

Rep. Tina Sablan said they did discuss those concerns with the Ways and Means last week as the latter deliberated on the budget bill for 2021. In her letter, Helen Sablan raised concerns about the CNMI being at risk of losing out on millions of Medicaid funds if the Legislature does do not identify additional CNMI funding to cover the administrative costs and the costs associated with developing fraud detection and prevention system.

Rep. Tina Sablan said it would be helpful for Attao and Blanco to just follow up on that by bringing in Medicaid for House members to questions. “It does appear that this may have been an oversight in the House, the governor’s part as well, but also as we deliberated on the House version,” she said.

The lawmaker said is it important to hear Medicaid so that they at the House are prepared and ready when the Senate does get to the House their budget version. “We should be sure that we take care of Medicaid,” Rep. Tina Sablan said.

Attao said they’re working on a bill with House Health Committee chair Jose I. Itibus (R-Saipan) on specific legislation in regards to Medicaid. Attao asked Itibus to follow up on that legislation.

Helen Sablan noted in her letter that there has been a substantial increase in the number of Medicaid beneficiaries due to the furloughs and layoffs, resulting from the COVID-19 pandemic. She said the requested funding is required to make reasonable and appropriate progress to administer the program and submit data and reports to the federal government.

Rep. Tina Sablan said the proposed House budget provides a total of $2.52 million for the Medical Assistance Program and Enhanced Allotment Plan of Medicaid, and $187,400 for the administration of the Medicaid program. She said as a federal-state/territory program, the administration costs are set in Title XIX to be 50-50% for program administration.

Helen Sablan said absolutely no funds were provided from the proposed fiscal year 2021 House budget for utilities, office supplies, or any other operational expenses that would be funded at 50-50%.

The director said the proposed House budget provided no funding for the Medicaid Enterprise Systems that were written into Title XIX because of the large amount of funding provided to the CNMI and the adjustment to matching percentage.

She said that, by not providing a territory match of 10% or $435,268 for the MES projects, the Commonwealth Medicaid Agency will not be able to make “reasonable and appropriate” progress and will jeopardize the current and future funding for the CNMI Medicaid program.