State budget hearing flags Medicaid and childcare funding risks as agency leaders warn of cliffs

INDIANAPOLIS — Leaders from the Family and Social Services Administration, the Department of Health and affiliated agencies warned the Senate State Budget Committee that two budget risks — possible federal changes to Medicaid funding and the way child-care expansion was paid for earlier this administration — could leave the state facing sizable shortfalls.

“What I want to do is make Medicaid boring again,” Mitch Roob, secretary of the Indiana Family and Social Services Administration, told the committee, arguing for clearer, longer-term budgeting and tighter fiscal controls. Roob and other agency leaders said the governor’s proposed budget would fully fund Medicaid to the December forecast but that uncertainty in Washington, D.C., and prior one-time state funding for childcare mean the next two years could produce abrupt gaps.

Why it matters: Indiana spends roughly $24.1 billion in the governor’s biennial request for programs managed through FSSA. Large unexpected changes to federal sharing formulas for Medicaid or to the financing of childcare initiatives could force rapid program changes or require substantial one-time or ongoing state funding to cover services and provider payments.

What agency leaders told lawmakers - Medicaid…