FOR IMMEDIATE NEWS RELEASE (April 10, 2019– Hagåtña) – Senator Therese M. Terlaje introduced Bill No. 78-35 (COR) to address the $5.6 million dollar shortfall the Department of Public Health and Social Services (DPHSS) is facing to pay Medicaid claims to private entities through the end of Fiscal Year 2019.
Based on claims received, current processing, and expenditure projections, DPHSS needs approximately $5.6 million dollars for local matching requirements and only has enough funding through the first week of April for regular Affordable Care Act (ACA) Medicaid and Medicaid Childless Adults claims from private medical providers.
The Medicaid Program subsidizes health care costs for approximately 43,549 low-income individuals. Appropriating $5.6 million dollars for local matching requirements for the Guam Medicaid program will allow DPHSS to access an additional $6.8 million dollars in federal Affordable Care Act (ACA) grant funds.
Senator Therese Terlaje first called attention to this shortfall in Medicaid funding during a February 7, 2019 informational briefing with DPHSS and with her introduction of Bills No. 35-35 and 36-35. At that time, DPHSS reported a potential $13.3 million dollar shortfall for local matching funds for Medicaid. Since then, an Executive Order was signed by the Governor to redirect $7.7 million dollars of the FY 2019 GMHA Pharmaceutical Funds back to DPHSS to pay GMH Medicaid claims, leaving a shortfall of approximately $5.6 million dollars for non-GMH Medicaid claims.
Still left untapped is approximately $61 million in federal ACA Medicaid funds that DPHSS is unable to tap due to a lack of local matching funds. All federal ACA funds expire in September 2019. This year Guam has already used $13.1 million of local funds to access $15.6 million of the ACA funds for Medicaid claims. A $10.5 million decrease in federal funds is indicated in the Governor’s 2020 budget request, and $3 million in Compact Impact funds are allocated towards Medicaid.
“With the many and current competing interests on our island, I still believe that one of our top priorities should be the health and wellness of our most vulnerable families who are eligible for Medicaid. There is an urgent need to invest in the local match requirement for Medicaid in this fiscal year, in order to access federal grant funds to pay for Medicaid claims. If we do not prioritize this now, we may lose our opportunity to tap into those federal ACA grant funds and many of our low-income families may not get the care that they need,” stated Senator Terlaje.
She further stated, “Clearly this situation was a priority months ago and today it is a potential crisis. DPHSS has exhausted its FY19 local Medicaid appropriation with five months left unfunded and $61 million in federal funds waiting to be tapped. The government cannot afford to cover these patients without the federal match, and our community cannot afford the risks of even a temporary shutdown in health services to these patients. The government must immediately allocate additional funds to DPHSS through this bill or the bill introduced two months ago, through the Governor’s transfer authority, or by redirecting Compact Impact funds.”