Medicaid’s capped funding could lead to $12M shortfall for CHCC
The CNMI’s Medicaid program’s capped funding is expected to result in a whopping $12-million shortfall for the Commonwealth Healthcare Corp. by the end of the fiscal year.
CHCC recently went before the Senate Committee on Fiscal Affairs’ budget hearing to inform them of the financial struggles they are currently facing and will continue to face if Medicaid does not get the much-needed funding.
In a statement to the Saipan Tribune, CHCC says the shortfall has resulted in a situation where CHCC anticipates not receiving payment for the services rendered, which has placed a strain on its resources and financial stability.
“The CNMI’s economic stability is currently unstable, which means more Medicaid-qualified applicants and enrollees. If Medicaid is not able to pay, it strains program participants to access care. Nonetheless, CHCC continues to serve an insured population whose insurance does not fully cover the cost of care, adding further pressure,” CHCC said in its statement.
During the Senate budget hearing, CHCC CEO Esther Muña asked the Senate to consider two things when considering their budget request; CHCC’s workforce and the organization’s ability to continue financing health care for members of the community who cannot afford it. Muña strongly emphasized the latter.
Aside from going before the Senate during a budget hearing, Saipan Tribune learned that Muña also shared the issue with Gov. Arnold I. Palacios and has also reached out to Medicaid, urging them to help CHCC avoid detrimental issues that could put its Centers for Medicare and Medicaid Services certification at risk as it would cost CHCC critical healthcare workers.
“CHCC is hopeful of the passage of H.R.949 by [Delegate] Gregorio Kilili Sablan (D-MP), which would amend Title XI of the Social Security Act to eliminate the general Medicaid funding limitations for U.S. territories. This provides the opportunity to no longer limit some of the services of patients under the program. However, there has been no movement in the U.S. Congress,” CHCC said in a statement.
Medicaid is a joint federal-state program that finances medical services for low-income individuals. However, U.S. territories like the CNMI operate Medicaid programs under rules that differ from those applicable to the 50 states.
For example, the CNMI’s Medicaid program operates under the Section 1902(j) waiver authority. Under this rule, the Medicaid requirements that may not be waived are the federal matching rate; the annual federal capped funding; and the requirement that Medicaid payments are for services otherwise coverable.
In a previous interview with Muña, she said that, with capped funding, it is difficult for Medicaid to consider future expansion of services, even though individuals will lose access to critical health care.
“I hope the capped funding is removed soon so there is a discussion to expand medical services and bring health initiatives to the CNMI,” she said.
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