“We
believe today’s action will help states as they struggle to maintain
Medicaid and other budget priorities in these difficult economic times,”
said Secretary Sebelius. “This relief will help states continue to
provide critical health care services to the nearly 60 million beneficiaries
who depend upon it.”
This
temporary financial boost to states is made possible by the American Recovery
and Reinvestment Act of 2009 (ARRA). That law granted a significant, yet
temporary, increase in the amount states receive from the federal government to
help pay for their Medicaid programs. The increase was to the
federal share of Medicaid costs, referred to as federal medical assistance
percentage payments (FMAP).
In a call with state governors today, Secretary
Sebelius reported that HHS will apply the ARRA increased FMAP to so-called
clawback payments. The clawback payment is the amount states pay to the
federal government as required by the Medicare Prescription Drug Improvement
and Modernization Act of 2003 (MMA). It is intended to offset some of the
added expense to Medicare Part D of assuming drug costs for residents dually
eligible for both programs. Prior to MMA, state Medicaid programs covered
prescription drug costs for these beneficiaries. Because Medicaid is a
state/federal matching program, the higher FMAP under ARRA results in a
temporary reduction of the states’ share of spending and therefore in
their clawback obligation.
This temporary adjustment in the clawback payments
will be applied for the period October 1, 2008 through December 31, 2010.
In his 2011 budget, President Obama calls for the FMAP increase established in
ARRA to be extended through June 30, 2011.
“In asking Congress to extend the
increased FMAP in his 2011 budget proposal, the President recognizes both the
critical role Medicaid plays in the health of our most vulnerable citizens and
difficulties states are experiencing given the economic downturn,”
Secretary Sebelius said.
States make clawback payments monthly and CMS is
currently reprogramming its billing system to calculate the new, reduced
payments owed by states. The savings, which are retroactive to October
2008, will be deducted from what they otherwise would have owed going forward.
The table below shows each state’s estimated
savings. Column B shows the state’s obligation under the pre-ARRA
formula with column C showing the newly calculated payment, column D the total
estimated savings to the state.
State (A)
|
Total Q1 FY 09 Thru Q1 FY 11 Clawback Based on Reg. FMAP (B)
|
Total Q1 FY 09 Thru Q1 FY 11 Clawback Based on ARRA FMAP (C)
|
Total State Savings/Fed. Cost Q1 FY 09 Thru Q1 FY
11 (D)
|
Alabama
|
$150,247,579
|
$106,425,199
|
$43,822,379
|
Alaska
|
$48,317,314
|
$38,286,755
|
$10,030,558
|
Arizona
|
$153,759,854
|
$108,954,983
|
$44,804,871
|
Arkansas
|
$87,089,886
|
$62,440,556
|
$24,649,330
|
California
|
$2,913,864,100
|
$2,238,430,401
|
$675,433,698
|
Colorado
|
$192,319,003
|
$150,066,687
|
$42,252,316
|
Connecticut
|
$296,665,054
|
$230,615,556
|
$66,049,498
|
Delaware
|
$34,099,374
|
$26,386,737
|
$7,712,637
|
District of Columbia
|
$25,602,876
|
$17,959,629
|
$7,643,248
|
Florida
|
$1,015,370,655
|
$732,819,868
|
$282,550,787
|
Georgia
|
$256,830,737
|
$186,189,524
|
$70,641,213
|
Hawaii
|
$60,409,856
|
$43,814,638
|
$16,595,218
|
Idaho
|
$46,562,615
|
$32,122,245
|
$14,440,370
|
Illinois
|
$875,508,052
|
$675,854,129
|
$199,653,923
|
Indiana
|
$209,694,287
|
$151,629,223
|
$58,065,064
|
Iowa
|
$162,359,071
|
$127,106,244
|
$35,252,826
|
Kansas
|
$113,478,227
|
$89,157,121
|
$24,321,107
|
Kentucky
|
$182,471,045
|
$127,408,848
|
$55,062,197
|
Louisiana
|
$203,392,153
|
$126,178,376
|
$77,213,777
|
Maine
|
$103,581,677
|
$75,744,571
|
$27,837,106
|
Maryland
|
$238,997,062
|
$187,197,783
|
$51,799,278
|
Massachusetts
|
$612,833,627
|
$480,102,616
|
$132,731,011
|
Michigan
|
$386,791,612
|
$285,445,457
|
$101,346,155
|
Minnesota
|
$360,083,533
|
$278,777,119
|
$81,306,414
|
Mississippi
|
$102,735,712
|
$65,989,013
|
$36,746,699
|
Missouri
|
$407,283,149
|
$299,443,677
|
$107,839,472
|
Montana
|
$28,771,325
|
$20,110,737
|
$8,660,588
|
Nebraska
|
$95,393,763
|
$76,664,267
|
$18,729,497
|
Nevada
|
$62,310,316
|
$45,031,768
|
$17,278,548
|
New Hampshire
|
$71,136,363
|
$56,982,733
|
$14,153,631
|
New Jersey
|
$696,147,055
|
$543,196,366
|
$152,950,689
|
New Mexico
|
$47,436,153
|
$33,768,936
|
$13,667,217
|
New York
|
$1,882,163,731
|
$1,474,399,935
|
$407,763,796
|
North Carolina
|
$552,941,188
|
$400,670,852
|
$152,270,335
|
North Dakota
|
$22,440,556
|
$18,259,530
|
$4,181,026
|
Ohio
|
$581,726,147
|
$430,246,974
|
$151,479,172
|
Oklahoma
|
$154,134,582
|
$106,156,483
|
$47,978,098
|
Oregon
|
$147,332,690
|
$108,155,974
|
$39,176,716
|
Pennsylvania
|
$1,000,611,930
|
$771,650,285
|
$228,961,645
|
Rhode Island
|
$97,366,309
|
$74,159,944
|
$23,206,365
|
South Carolina
|
$168,667,834
|
$117,154,008
|
$51,513,826
|
South Dakota
|
$31,593,895
|
$25,104,607
|
$6,489,288
|
Tennessee
|
$442,828,611
|
$321,494,820
|
$121,333,791
|
Texas
|
$777,317,414
|
$567,316,054
|
$210,001,360
|
Utah
|
$57,174,136
|
$39,826,114
|
$17,348,022
|
Vermont
|
$49,485,228
|
$36,881,632
|
$12,603,596
|
Virginia
|
$390,311,646
|
$304,575,535
|
$85,736,111
|
Washington
|
$359,451,673
|
$273,090,100
|
$86,361,573
|
West Virginia
|
$71,905,352
|
$48,544,797
|
$23,360,555
|
Wisconsin
|
$476,178,882
|
$358,970,479
|
$117,208,403
|
Wyoming
|
$23,393,068
|
$18,935,147
|
$4,457,921
|
TOTAL
|
$17,528,567,954
|
$13,215,895,031
|
$4,312,672,922
|
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