 Eileen Ellis of Health Management Associates said the state's
current base rate of 50.2 percent will drop to the floor rate of 50
percent come Oct. 1. The base rate is the percentage of Medicaid
costs that are absorbed by the federal government.
"Illinois does benefit from the floor -- otherwise, it would be at
49.56 percent," Ellis said.
The $30 million is basically a drop in the bucket of a total annual
$15 billion Medicaid budget, but it's additional money the state
will have to come up with as it faces a budget deficit that could
reach $13 billion or more.
A spokesman for the state Department of Healthcare and Family
Services declined to comment on Ellis' proprietary data since it
could not be immediately verified. The data was referred to in a
Kaiser Health News/Texas Tribune story.
"We're very focused on working with the Legislature to make the
program more efficient as well as improve health outcomes," said
Mike Claffey.
Both the Illinois House and Senate have formed special legislative
committees to reform the state's Medicaid system.
Medicaid is the state-federal health insurance program for the poor
and disabled. The formula used to figure out the federal share of
the costs -- called the Federal Medical Assistance Percentages, or FMAP
-- is based on a state's per capita income and a benchmark
federal share of 55 percent. The program has a federal floor of 50
percent, so no state will be forced to pay more than half the costs.
If a state's per capita income is the same as the national average,
it receives a federal share of 55 percent. Illinois' per capita
income has usually run higher than the national average, so its FMAP
has always hovered around 50 percent.
The state's current base FMAP for fiscal 2011 stands at 50.2 percent,
which Ellis has calculated will drop to 50 percent in October, when a
new federal fiscal year starts. That's just three months after
Illinois and the rest of the states will stop getting an enhanced
Medicaid reimbursement rate -- with Illinois gradually ratcheting
down from 61.88 percent this December -- from federal stimulus
dollars.
It could be worse. Of the 21 states set to see an FMAP drop, North
Dakota leads the pack at 4.5 percentage points, Ellis said.
Illinois state lawmakers have always pointed toward other states
that get a higher base federal matching rate and said, "Why can't we
get that?" Because state residents earn too much money, according to
Ellis.
[to top of second column] |
Granted, a state's base FMAP can change over the years, primarily
because of a decrease in per capita income.
Just look at Michigan, she said. Its base FMAP rate stood at 56.36
percent in fiscal 2002. Now, it stands at 65.79 percent.
Ellis said lawmakers' complaints do have some substance. A
significant lag time exists between the federal government's
calculation of personal income and its setting of each state's share
of federal dollars. For example, the per capita incomes of fiscal 2007,
2008 and 2009 are used to establish the fiscal 2012 FMAP, she said.
Additionally, the federal formula does not recognize the rate of
uninsured individuals in each state, she said.
Chances for lobbying Congress to change the formula are "remote,"
Ellis said, since federal lawmakers fear having to pick up more of
the tab. And the states and territories would have their say.
"There are 50-plus self-interests to change, if this were open to
change," she said.
[Illinois
Statehouse News; By MARY MASSINGALE]
 |
