Saying the ripple effects of losing $28 million in federal Medicaid money will be devastating, Reps. Christina E. Sablan (D-Saipan) and Donald M. Manglona (Ind-Rota) urged Gov. Ralph DLG Torres Tuesday to exercise his 25% reprogramming authority under the Planning and Budgeting Act to immediately transfer the required $5 million local matching funds to the Commonwealth Medicaid Agency.
In their joint letter to Torres, Sablan and Manglona said the governor may also direct the Finance secretary to expeditiously provide the House of Representatives with an updated status of all accounts to assist them in identifying the funding sources for an amendment to Public Law 22-08, the Annual Appropriations Act for Fiscal Year 2022.
Sablan and Manglona chair the House Health and Welfare Committee and House Ways and Means Committee, respectively.
During the Health and Welfare Committee meeting last Thursday, acting director for the CNMI Medicaid Agency Vicenta Borja disclosed that if there is no available $5 million local match for Medicaid’s federal allotments for fiscal year 2023, the CNMI must return $28 million in available funds.
Borja and other CMA officials explained that American Rescue Plan Act funding cannot be used to meet the local matching requirement for Medicaid as previously believed, pursuant to a rule issued by the U.S. Treasury Department, the final rule implementing the Coronavirus State and Local Fiscal Recovery Funds.
As a result, Borja said, if approximately $5 million for the local match is not identified and remitted in this current fiscal year, the Commonwealth will have to return an estimated $28 million to the federal government.
Sablan and Manglona told Torres that the consequences of losing $28 million in Medicaid funding will be catastrophic for Marianas residents.They said the CMA will have to shut down critical services and suspend payments to providers and vendors.
The lawmakers said the Commonwealth Healthcare Corp. will then be the only healthcare provider available to Medicaid patients, further straining CHCC’s medical staff and resources and exacerbating already-long wait times for appointments.
Sablan and Manglona said an estimated 24,000 people availing of Medicaid now through Presumptive Eligibility may be prematurely disenrolled even before the national public health emergency ends, and this is expected to drive up the cost of uncompensated care for CHCC.
They said that, as Borja noted during the meeting last week, the people who will be hurt the most and immediately will be patients in need of medical referral, whose access to off-island care will be disrupted.
“Relationships with off-island providers may also be jeopardized and will be difficult to rebuild,” Sablan and Manglona said.
They told Torres that the urgency of this matter demands swift resolution.The lawmakers said their two proposed courses of action will address the local funding needs of the CMA and to protect the interests of the 38,000 residents now enrolled in Medicaid.
Noting that there may be other potential solutions, Sablan and Manglona said they are ready to assist in their capacities as chairpersons of House committees and as House members.