balancing georgias medicaid & chip budgets tim sweeney sr. healthcare analyst georgia budget...
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Balancing Georgia’s Medicaid & CHIP Budgets
Tim Sweeney Sr. Healthcare Analyst
Georgia Budget & Policy Institute
January 29, 2010
Setting the Stage
Political Climate Very Conservative, yet paternalistic
Budget & Revenue Picture Low taxes & spending levels pre-recession
Existing Medicaid Program Low parental eligibility (≈50% FPL) Low reimbursement rates Administrative barriers (income/identity/cit doc)
GA Facing Dramatic Revenue Loss
Original FY 2009 Estimate = $20.1 B Actual FY 2009 Revenue = $16.8 B Revised FY 2010 Forecast = $15.6 B
Original FY 2009 Medicaid/CHIP = $2.1 B Actual FY 2009 Medicaid/CHIP = $1.5 B Revised FY 2010 Medicaid/CHIP = $1.4 B
Balancing FY 2010
Pre-ARRA Governor proposed hospital & HMO taxes or
Medicaid provider rate cuts Legislature recessed while congress debated ARRA
Recovery Act funding was crucial for Medicaid Estimated $726 M (FY 2010) in savings due to
enhanced FMAP Enhanced federal share ≈ 75% Expiration created hole in FY 2011 & FY 2012
FY 2011
Recovery Act & one-time funds expiring Agency forecasts $600+ million hole
Gov proposes provider taxes Funds very limited enrollment growth
Gov’s budget assumes 6-month extension of ARRA-enhanced FMAP $378.5 M hole remains without extension
Governor Proposes Provider Taxes 1.6% provider taxes
$247.1 M from hospitals $97.1 M from managed care orgs
Funds directed for rate increases, enrollment growth, replacing 1-time funds Generates or protects $1 billion in federal funds Lots of opposition
Gov & agency threaten 16.5% rate cuts without new fees
GA in Need of Additional Revenues
Gov predicting $2.6 B shortfall in 2012 Revenue options exist:
Cigarette Tax: $1/ pack raises ≈ $400 million Temp. 1% surtax on income > $400k raises ≈
$225 million Reduce caps and values of existing tax credits
and exemptions Close corporate tax loopholes
Contact Info
Tim Sweeney100 Edgewood Ave, Suite 950
Atlanta, GA 30303
404.420.1324
www.GBPI.org