Federal government will pay more toward Medicaid in V.I.
Published: April 30, 2014
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ST. CROIX - The federal government has agreed to pay a slightly larger portion of Medicaid costs in the territory, at least temporarily, and will also pick up a significantly larger share of the tab for a new demographic that the territory plans to add to its Medicaid rolls later this year.
The more the federal government pays, the less the territory has to pay for the program. The saved money can potentially then be used to expand the program to help more people, officials said.
"In the big scheme of things. I think what's important is that at least it's moving in the right direction," V.I. Human Services Commissioner Chris Finch told The Daily News.
The Human Services Department administers the territory's Medicaid program, the Medical Assistance Program.
Medicaid is the nation's health care program for the poor. The states or territories share the cost of Medicaid with the federal government and create their own program plans, so Medicaid programs vary from jurisdiction to jurisdiction.
The U.S. Centers for Medicare and Medicaid Services, CMS, notified Finch last week that an analysis the territory compiled and submitted earlier this year proved that the territory met the requirements under the Affordable Care Act to be considered a Medicaid Expansion State.
Therefore, the territory qualifies to receive a larger federal share for the Medical Assistance Program. The report was put together by consultants, Finch said.
Under a funding formula, the federal government picks up a higher percentage of Medicaid costs for poorer states. But for the territories, the federal share used to set by law at 50 percent - the lowest level. The Affordable Care Act raised the federal funding percentage for the territories to 55 percent.
However, with the changes that CMS confirmed last week:
- The federal government will increase its funding percentage to the territory by 2.2 percentage points, from 55 percent to 57.2 percent, for all patients in the Medical Assistance Program for two years, retroactively to the beginning of this year.
- When the territory expands its Medicaid program to include a new demographic - low-income childless adults who are not pregnant - the federal government will pick up 78 percent of the cost for that new group, leaving the territory with only 22 percent to pay on that group's tab. The federal funding percentage for the new population will increase gradually up to 90 percent in 2019, the year the Affordable Care Act expires, Finch said.
Human Services hopes to bring that population into the Medical Assistance Program later this year, in the late summer or fall, he said.
The reason for the delay is that other Medical Assistance Program expansions have been in the works and will happen sooner, according to Finch.
"It's because of the other expansions and just the capacity of how many people you can bring on at one time with the existing staff and offices and the need to upgrade the computer system," he said.
Currently, Human Services is in the process of trying to enroll an estimated 4,700 people in the territory who already qualify for the Medical Assistance Program but are not enrolled, he said.
According to Finch, they have been identified through information that qualified them for the SNAP program - formerly known as Food Stamps - a program Human Services also administers. Human Services intends to start sending out pre-enrollment letters to that group after Carnival ends this week.
"We want to bring them in," Finch said. "We're trying to make it very easy for this group."
Once that is done, Human Services plans to expand the Medical Assistance Program by raising the income limits for current demographic groups in the program: families with children; senior citizens; and persons with disabilities, he said.
That will enable more residents in those existing categories to qualify for help. Currently, only the poorest of the poor qualify for Medicaid in the territory.
Once the income limits are raised, Human Services plans to expand the Medical Assistance Program to the new demographic group, low-income childless adults, Finch said.
A statement Government House released about the expansion last week noted that because the new demographic "also potentially includes persons with some mental illnesses, this may go a long way to assist closing mental health system gaps in the territory for this specific population."
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