Medicaid forecast a gross injustice for vulnerable Hoosiers

Today, during the State Budget Committee meeting, it was revealed that Medicaid will be underfunded in Indiana by roughly $1 billion. State Rep. Gregory W. Porter (D-Indianapolis) issued the following statement:

“In recent years, the Medicaid forecast has usually been somewhat on track and, if anything, over forecasts what is needed when it comes to the State General Fund appropriation. This program is matched by the federal government at around 65%, meaning for every dollar spent on Medicaid, the federal government contributes about 65 cents. 

“This underfunding of such a critical program is an unfortunate surprise that was hidden from the General Assembly until the last minute, and now leaves the Medicaid program to scramble to figure out which programs they are going to have to cut. Several Medicaid programs – including Applied Behavioral Therapy for autism and pediatric dentistry – are already not receiving adequate compensation. These programs are vital to improving public health outcomes for Hoosiers.

“Medicaid is a life-sustaining program for so many Hoosiers across the spectrum of years. From prenatal care to the eldest of our citizenry receiving services in home and community-based services, millions of Hoosiers depend on Medicaid to receive health care. This is a gross injustice for vulnerable Hoosiers.

“I'm at a loss on how such a substantial and substantive error was not caught, especially considering Indiana avails itself of one of not the premier actuary in the nation in the field of providing Medicaid estimating services for our state along with many states throughout the country. We need to ask why we didn't receive this information prior to July 1st of this year, when the State Budget Agency reverted $700 million to the General Fund at the close-out of the budget. Was the State Budget Agency not aware that there was no money that could or should have been reverted?

“I would like to say for the record that the House Democratic Caucus has often protested against the reversion of money intended for Medicaid for uses other than what it was appropriated for. Further, we have also contested and questioned why other money intended for Medicaid has been repeatedly sent or diverted to non-Medicaid activities such as funding the Hepatitis-C remediation lawsuit program at the Indiana Department of Corrections or supplementing the 2021 Department of Corrections medical services program. I am not questioning the need for funding these programs; however, I am questioning the diversion of Medicaid dollars to non-Medicaid programs when the state had over a $3 billion surplus at the time of the diversion.

“This is a stark reminder that we must protect Medicaid to the best of our ability as a state. Let's not make the cuts on the backs of those receiving services or our providers. Let's rise to the challenge and do the following:

“In fiscal year 2024, we must use the approximated $620 million in the Medicaid reserve to backfill the missing money and forestall cuts, as well as any additional money that we need to take from our approximate $2 billion surplus. After fiscal year 2024 closes, we need to take all of the remaining dollars needed to close the funding gap from the hundreds of millions of dollars that will most likely be reverted and use those dollars to eliminate any remaining 2025 Medicaid funding gaps.

“A long-term way to tangibly protect Medicaid is to follow what Al Gore called for to secure Social Security funding going forward. As a presidential candidate, he called for a 'lock box' that would put all Social Security dollars not needed into a Social Security savings account. We need to get a 'lock box' for Medicaid in the future and mandate that any and all money not needed for the Medicaid appropriation be placed in the Medicaid Reserve, safe from reversion and diversion.

“Lastly, every dollar that is not spent at the state level leads to about $2 not being provided as match for Medicaid programs. We cannot and should not subtract $3 billion from our health care safety net infrastructure. This should be the clarion call for the General Assembly when session begins in January.

“As they say, 'let's get it done.'”