Speculation was rampant over the past year regarding exactly how full implementation of the Affordable Care Act (ACA) (Obamacare) would actually affect the current healthcare programs, like Medicare and Medicaid. Now, with President Obama’s re-election in place and the long-term security of the ACA secure, we are beginning to see some possible ways that the program is going to alter current state practices. For one thing, it may act as a spur to modernize the interaction between various state agencies, including Medicaid.
For example, as discussed in a recent Albany Times Union editorial, the federal Centers for Medicare and Medicaid (CMS) is making a one-time offer to states of 90% matching funds for “modernization” efforts. What does this mean? States will have a significant incentive to spend some resources to improve the efficiency of its programs, including Medicaid. This increased matching fund effort was spurred by the “health exchange” components of the ACA.
In general, CMS pays 50% of Medicaid costs, and the state pays the remaining 50%. That is why Medicaid is deemed a joint state and federal program. However, as part of this new push to improve certain aspects of the program, when a state wants to work on a modernization project, instead of paying for half of the cost of the project, they would only have to pay 10%, with federal coffers taking care of the remaining 90%.
What is a modernization project?
The article notes the 90/10 matching arrangement would apply to improving New York’s “shared eligibility services” among various public programs. Medicaid is just one of many different programs that seek to provide aid to community members with limited means. Others include Temporary Assistance for Needy Families (TANF), Supplemental Nutrition Assistance Program (SNAP), and similar efforts. Right now, each of these programs has different rules for eligibility and different application processes. The result of all of this separation is increased administrative costs for running the progams. One goal is to modernize this by combining the eligibility criteria for all three–making the programs work together more efficiently.
However, it remains unclear if New York will take advantage of the CMS 90/10 offer and work to modernize these program eligibility issues. The editorial calls on state officials working on these matters to apply for the enriched CMS funds; they have yet to do so. The CMS offer was first put forward in 2011 and will expire in 2015. That means that there is still time for administrators and policymakers to take advantage. Yet, this eligibility modernization effort would likely only come as part of larger-scale reforms of the system Considering Governor Cuomo’s penchant for efficiency, however, it seems logical that this would be part of the overall long-term plan.
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