Kilili to testify on lifting Medicaid caps

WASHINGTON, D.C.—Delegate Gregorio Kilili C. Sablan (Ind-MP) will testify today on the need to provide more funding for the Marianas Medicaid program. The House Energy and Commerce Subcommittee on Health has called a hearing to address the looming crisis for all the insular areas as temporary funding for Medicaid runs out Oct. 1.

Sablan secured over $124 million for Marianas Medicaid in the last Congress. But that one-time money will no longer be available at the end of fiscal year 2021.

Sablan has introduced legislation, H.R. 265, that would get rid of the fixed cap on Medicaid for U.S. territories permanently. His legislation has 60 cosponsors, including the House Appropriations Committee chair, Rep. Rosa DeLauro (D-Connecticut). The two Republicans who represent American Samoa and Puerto Rico have also cosponsored Sablan’s legislation.

If the cap goes back into effect on Oct. 1, Medicaid funding for the Marianas will drop from $62.3 million in this fiscal year to $7.2 million in fiscal 2022. Guam, American Samoa, the Virgin Islands, and Puerto Rico would all see similar 85 to 90% cuts.

Another ‘cliff’

This is not the first time the insular Medicaid programs have faced a funding cliff. Using his authority as vice chair for Insular Affairs, Sablan called a hearing of the House Natural Resources Committee on May 23, 2019, to focus attention on the end of Medicaid funding from Obamacare that the Marianas and all the U.S. territories faced at the end of that fiscal year.

Commonwealth Healthcare Corp. chief executive officer Esther Muña and CNMI Medicaid director Helen Sablan, together with the Medicaid directors from all other insular areas, testified at Sablan’s hearing—a first. The directors described the life and death choices they faced with limited funding.

Congress quickly responded with $120 million in new funding in Public Law 116-94 and again in Public Law 116-127 with additional money.

The health insurance Medicaid provides for persons with lower incomes has been especially important during the pandemic. Enrollment in the Marianas Medicaid program has doubled from about 16,000 two years ago to 32,000 now.

But Medicaid is important for everyone in the Marianas. Medicaid is almost half the revenues of the CHCC. And, according to CHCC, without that Medicaid income, the Marianas’ only hospital would close.

With the additional funding Sablan secured, however, CHCC has been able to invest in better care. The hospital’s new Oncology Center has reduced the need for off-islands referrals for cancer treatment from 307 patients in 2019 to just 25 last year. (PR)