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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
Medicaid Match Extension Map
States are counting on Congress passing a six-month extension to the enhanced Medicaid matching rates originally enacted in the federal stimulus package.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.

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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