Republicans seek to cut $26M in Medicaid for NMI

U.S. Delegate Gregorio Kilili C. Sablan (Ind-MP) and Gov. Ralph DLG Torres slammed yesterday a cut of about $26 million in crucial Medicaid funding for the Northern Marianas, which came as part of a vote by the U.S House Republican majority to repeal the Affordable Care Act, widely known as Obamacare.

The move cuts similar funding for American Samoa, Guam, Puerto Rico, and U.S. Virgin Islands.

“I just do not understand how any political party can justify taking so much from people who have so little,” Sablan said in a statement yesterday. He called the move one that would end all of the funding—another $57 million in the Affordable Care Act pipeline between now and 2019—to the CNMI in 2017—a loss of about $26 million to the local hospital and to the low-income families who depend on Medicaid to pay for their health care.

The repeal is the Republican Party’s latest attempt to gut President Barack Obama’s signature health care law, a five-year-and-counting effort that has survived U.S. Supreme Court scrutiny and attempts by U.S lawmakers to overhaul the legislation. This is the first time a full repeal has made it to the White House, after dozens of previous votes.

Obama is expected to soundly veto the bill—H.R. 3762—which House Republicans and Speaker Paul Ryan have argued as a symbolic effort to confront Obama with alleged failures of the law.

Ryan has pledged that the House will come up with its own plan this year—something the GOP has repeatedly promised but failed to do in the nearly six years since the law’s enactment, according to an Associated Press report yesterday.

Regardless of the politics surrounding the Affordable Care Act in Washington, D.C., Gov. Ralph DLG Torres told Saipan Tribune in an email yesterday, “the fact of the matter is that Medicaid services provide access to healthcare to a vast number of our residents.”

“To reduce the federal funding for this important program that provides for lower-income households in the CNMI does a disservice to the disproportionate amount of the population living under the federal poverty guidelines,” added Torres.

Federal Medicaid match decreased

Republicans also voted to raise the local match required for Medicaid to 50 percent. The Affordable Care Act had lowered the local share for the insular areas to 45 percent.

Sablan called this a “setback,” on top of the straight loss to federal Medicaid dollars. He noted that the Affordable Care Act took a step in the right direction by changing the local/federal cost-share from 50/50 to 45/55, “giving the CNMI a better local/federal match than 22 states.”

If the CNMI were treated exactly like a state and the match were calculated based on income levels in the Marianas, Sablan said, it would be in the neighborhood of “20 percent local and 80 percent federal.”

“Being treated like a state for Medicaid remains my goal,” said Sablan. “But today’s Republican vote takes us in the opposite direction.”

Under the Affordable Care Act, Medicaid funding increased from about $50 million to $158 million over the 10-year period ending in September 2019—a three-fold increase.

Sablan is now looking at what comes after 2019, saying that the local hospital and poor families cannot go back to the days when the CNMI received only $5 million per year for Medicaid.

“We should be enacting legislation that continues—or expands—the new funding provided by the Affordable Care Act. Instead, the majority wants to take us backwards to the way Medicaid worked in the Northern Marianas before 2009,” said Sablan.

In his email, Torres applauded Sablan’s efforts to protect the Medicaid program and “our ability to continue the necessary work to improve the overall health outcomes of our people.”