Clarifications on Medicaid


Medicaid patients and the private clinics and pharmacies that provide them service are the latest victims of the government’s “austerity” squeeze, as you reported in Medicaid benefit cuts in the offing, July 4, 2012. Services are being cut. No more dental care. Optometry and eyeglasses out. No more prescription drugs paid for.

So people need to know what’s really going on.

We get 55 cents in federal Medicaid money for every 45 cents the Commonwealth spends providing health care to citizens with low incomes. That’s a good deal for a cash-strapped government with lots of people who can’t afford insurance.

As recently as last September the Commonwealth used the favorable 55-45 split to draw down $8,121,000. That money and the 55-45 rate are both part of Obamacare, which the Supreme Court upheld last week.

Obamacare can be confusing, however. So I wanted to make a correction to your story. Our Medicaid rate does not return to 50-50, as it had been before the new law. The rate stays at 55-45 through 2014 and beyond-unless Republicans in Congress repeal the law, which they have promised to do.

Your story also includes the statement that some U.S. states “enjoy 100 percent coverage.” This, too, is not true. The most favorable rate in the current fiscal year is 74-26 for the state of Mississippi.

What is true is that the 55-45 rate for the Northern Marianas and all the U.S. insular areas is actually better than the rate for 16 of the U.S. states, including Alaska, California, Colorado, Connecticut, Hawaii, Illinois, Maryland, Massachusetts, Minnesota, New Hampshire, New Jersey, New York, Rhode Island, Virginia, Washington, and Wyoming.

Of course, our current rate does not account for income levels in the Northern Marianas. If it did, our federal-local match would be like Mississippi or better.

That’s why I have co-sponsored the Health Equity and Accountability Act, H.R. 2954, which will give the Commonwealth the best rate available to any U.S. state.

With Republicans now in control of the House and sworn to repeal our current 55-45 split, the Health Equity and Accountability Act doesn’t have much of a chance. But continually improving the federal-local rate, as we did in Obamacare, is our long-term goal.

In the short-term we have to block Republican attempts to repeal Obamacare and take away the new Medicaid money-about $100 million for the Northern Marianas-and the better rate we have already gained.

We have to believe that in time the Commonwealth government finances will improve. When that happens, the new $100 million will still be there to pay for those who can’t afford health care.

And those Medicaid dollars will help CHC and will also help keep in business the private practice doctors, dentists, opticians, and pharmacists who serve us all.

Gregorio Kilili Camacho Sablan
Member of Congress
Washington, D.C.

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