Only $63 million in ACA funding left for CHCC

There is only $63 million left available to the Commonwealth Healthcare Corp. under the Affordable Care Act and it has only four fiscal years left to spend the entire amount.

CHCC is the main beneficiary of $109 million in ACA funds for the Medicaid program in the Commonwealth.

As of April 30, 2015, CHCC has already received a total of $46.1 million of that amount, according to Delegate Gregorio Kilili C. Sablan’s (Ind-MP) chief of staff, Bob Schwalbach.

The current rate of use of these ACA funds is about $1 million per month until fully expended at the end of fiscal year 2019. These funds were made available starting in July 2011 when CHCC became the main beneficiary with its creation in October 2011.

Schwalbach said that aside from this special appropriation of funds under ACA, the Commonwealth is also eligible for Medicaid funds of about $5.5 million per year.

Esther Muña, chief executive officer for CHCC, said that they continue to benefit from the ACA funds. However, she emphasized that the Medicaid cap and the Federal Medicaid Assistance Percentage still needs to be changed by Congress.

FMAP is the percentage rates used to determine the matching funds allocated annually to certain medical and social service programs in the United States. FMAP eligible programs are joint federal-state partnerships between the federal government and state governments, and are administered by the states.

Muña said that currently, Medicaid gives a little over $6 million annually to the CNMI, which is not enough for the over 15,000 Medicaid-eligible residents of the islands. The current FMAP is 55 percent, largely due to ACA. After 2019, the FMAP will return to 50 percent.

“These are just some of our daily concerns when trying to provide quality health care to our people. If the Medicaid statute is not changed, it will be even much more difficult for CHCC to do just that,” Muña said.

“It will take more support from the non-voting delegates from the U.S. territories. There needs to be more support from other members of the U.S. Congress and they need to understand that Americans on this side of the world are obviously at a disadvantage when it comes to healthcare,” she added.

Despite the additional monies from ACA, the question still remains as to what will happen once the funding is over.

Delegate Sablan earlier told Saipan Tribune that the CNMI needs to start looking at 2019 when the funds for the CNMI and other territories expire.

“The congressional act that places a cap on Medicaid funding and places a flat FMAP for the territories needs to be amended and treat territorial residents the same as residents in the U.S. states,” Muña said.

“The regulations imposed on our hospital are tough considering there is inconsistency in the law when it comes to territorial hospitals. …On top of that, we are the sole hospital in the CNMI and a rural hospital as well,” she added.

A business plan that CHCC is finalizing now hopes to answer what CHCC will do once the ACA funding expires in 2019.