CSG Analysis
For Immediate Release
March 9, 2010
Contact: Jennifer Burnett
jburnett@csg.org
(859) 244-8114
States Bet Budgets on Medicaid Match Extension
By Jennifer Burnett, CSG Senior Research Analyst and Debra Miller, CSG Health Policy Director
States are counting on Congress passing a six-month extension to the enhanced Medicaid matching rates originally enacted in the federal stimulus package. That increased matching amount—worth around $25 billion to states—is currently set to expire Dec. 31, 2010.
According to a survey by The Council of State Governments, 24 states are betting their budgets on the federal Medicaid match extension even though the measure hasn’t yet passed. This includes New Jersey Gov. Chris Christie's proposed budget annouced yesterday.
The original federal stimulus package provided $87 billion for states’ Medicaid programs. The states used that money to avoid huge cuts in their state health programs as their revenues shrank and unemployment swelled Medicaid rolls. Even with the additional funds, some states were forced to cut reimbursement rates to providers and eliminate non-mandatory services such as dental and vision care. The increased matching rate was originally due to expire at year’s end and states have clamored for an extension to further stave off new and deeper cuts.
On March 10, the U.S. Senate approved its second jobs bill that includes a six-month extension of the enhanced Medicaid matching formula worth about $25 billion to states. The Senate bill differs from the House version passed in late 2009.
In the 24 states assuming Congress will pass the extension, the states’ recommended budgets depend on that extension for funding into 2011, from Jan. 1, 2011, to June 30, 2011.
Nineteen states took a more fiscally conservative approach and did not assume funding not yet approved by Congress. In 22 states, the governors did not include the assumption in their original budgets, but in three states—Kentucky, Iowa and Washington—the legislatures did count on the six-month enhanced Medicaid match in their revenue projections when the governors did not.
Under the Washington budget calendar, Gov. Christine Gregoire made her recommendations in December before the extension of the enhanced Medicaid match was even being discussed in policy circles and both chambers of the legislature have included the enhanced matching funds.
In New Mexico, the governor’s budget recommendations included the extension, but the original legislative budget did not. The most recent version of the budget sent from the legislature to the governor’s desk, however, placed the extension assumption back into their calculations.
In Kansas, under that state’s budget process, the governor will have an opportunity to offer a budget amendment in May and may include the additional federal Medicaid funds if it’s passed or seems likely to pass.
North Carolina is due to take up 2011 fiscal year budgeting later this year and the governor’s budget proposal is not yet due. Another six states—Indiana, Montana, New Hampshire, North Dakota, Ohio and Texas—have already passed their 2011 fiscal year budgets and at this time the budgeting process has not been reopened.
Is Medicaid Match Extension Included in States' 2011 Fiscal Year Budgets?
State |
Extension included?* |
Legislative cycle |
Budget cycle |
Notes |
Alabama |
Yes |
Annual |
Annual |
|
Alaska |
Yes |
Annual |
Annual |
|
Arizona |
No |
Annual |
Annual |
|
Arkansas |
No |
Annual |
Annual |
|
California |
Yes |
Annual |
Annual |
|
Colorado |
Yes |
Annual |
Annual |
|
Connecticut |
Yes |
Annual |
Biennial (2010-2011 fiscal year, adopt 2009) |
|
Delaware |
No |
Annual |
Annual |
|
Florida |
Yes |
Annual |
Annual |
|
Georgia |
Yes |
Annual |
Annual |
|
Hawaii |
No |
Annual |
Biennial (2010-2011 fiscal year, adopt 2009) |
|
Idaho |
Yes |
Annual |
Annual |
Budget assumes the extension, but also identifies contingency funds if the extension fails |
Illinois |
Yes |
Annual |
Annual |
|
Indiana |
N.A. |
Annual |
Biennial (2010-2011 fiscal year, adopt 2009) |
Budget not open in 2010 |
Iowa |
Yes |
Annual |
Annual |
Governor's budget did not include extension, but legislative budget did |
Kansas |
No |
Annual |
Annual |
Governor could include in April legislative amendment |
Kentucky |
Yes |
Annual |
Biennial (2010-2011 fiscal year, adopt 2009) |
Included in the House budget |
Louisiana |
No |
Annual |
Annual |
|
Maine |
Yes |
Biennial |
Biennial (2010-2011 fiscal year, adopt 2009) |
|
Maryland |
Yes |
Annual |
Annual |
|
Massachusetts |
Yes |
Annual |
Annual |
|
Michigan |
Yes |
Annual |
Annual |
|
Minnesota |
Yes |
Annual |
Biennial (2010-2011 fiscal year, adopt 2009) |
|
Mississippi |
No |
Annual |
Annual |
|
Missouri |
Yes |
Annual |
A,B |
|
Montana |
N.A. |
Biennial |
Biennial (2010-2011 fiscal year, adopt 2009) |
No regular session, 2010 |
Nebraska |
No |
Annual |
Biennial (2010-2011 fiscal year, adopt 2009) |
|
Nevada |
Yes |
Biennial |
Biennial (2010-2011 fiscal year, adopt 2009) |
Special session called Feb. 23, 2010 for budget |
New Hampshire |
N.A. |
Annual |
Biennial (2010-2011 fiscal year, adopt 2009) |
Budget not open in 2010 |
New Jersey |
Yes |
Annual |
Annual |
|
New Mexico |
Yes |
Annual |
Annual |
|
New York |
Yes |
Annual |
Annual |
|
North Carolina |
N.A. |
Annual |
Biennial (2010-2011 fiscal year, adopt 2009) |
2010 session begins May 2010 |
North Dakota |
N.A. |
Biennial |
Biennial (2010-2011 fiscal year, adopt 2009) |
No regular session, 2010 |
Ohio |
N.A. |
Annual |
Biennial (2010-2011 fiscal year, adopt 2009) |
Budget not open in 2010 |
Oklahoma |
No |
Annual |
Annual |
|
Oregon |
No |
Biennial |
Biennial (2010-2011 fiscal year, adopt 2009) |
Special budget session, 2010, concluded |
Pennsylvania |
Yes |
Annual |
Annual |
|
Rhode Island |
Yes |
Annual |
Annual |
|
South Carolina |
No |
Annual |
Annual |
|
South Dakota |
No |
Annual |
Annual |
|
Tennessee |
No |
Annual |
Annual |
|
Texas |
N.A. |
Biennial |
Biennial (2010-2011 fiscal year, adopt 2009) |
No regular session, 2010 |
Utah |
No |
Annual |
Annual |
|
Vermont |
No |
Annual |
Annual |
|
Virginia |
No |
Annual |
Biennial (2010-2011 fiscal year, adopt 2009) |
|
Washington |
Yes |
Annual |
Biennial (2010-2011 fiscal year, adopt 2009) |
Governor's budget released in 2009 did not include extension, but both legislative chambers are including extension |
West Virginia |
No |
Annual |
Annual |
|
Wisconsin |
No |
Annual |
Biennial (2010-2011 fiscal year, adopt 2009) |
|
Wyoming |
No |
Annual |
Biennial (2010-2011 fiscal year, adopt 2009) |
Refers to if the enhanced American Recovery and Reinvestment Act Medicaid match extension for Jan. 1, 2011, to June 30, 2011. Source: The Council of State Governments Survey