JFAC hears Medicaid budget increases, $190 million hospital assessment and $367 million forecast adjustment

The Joint Finance-Appropriations Committee on Wednesday heard a presentation on the Division of Medicaid’s budget showing multi‑hundred‑million‑dollar adjustments driven by caseload growth, provider rate changes and federal funding calculations.

Alex Williamson, budget and policy analyst with Legislative Services, told the committee that the division’s fiscal picture includes five budgeted programs — administration, coordinated (seniors and dual eligibles), enhanced (people with disabilities and foster children), basic (pregnant women and children) and expansion (adults up to 138% of the federal poverty level). "The division of Medicaid is responsible for administering plans to finance and deliver health services for people at risk due to low income and other factors," Williamson said.

Why it matters: Medicaid is an entitlement program with a substantial federal funding component; recent changes — including the 2020 Medicaid expansion go‑live, COVID‑era impacts, provider rate increases and adjustments to how upper‑payment‑limits are calculated — have increased the state’s outlays. Director Alex Adams of the Department of Health and Welfare described the department’s submission as “as close to a maintenance budget as I could submit,” noting that even without policy expansions the budget rose because of forecasted caseload, pricing and utilization.

Key figures and requests presented

- Hospital assessment supplemental: A request for $190,000,000 in trust/benefit payments, of which Williamson said $77,000,000 would come from the hospital assessment fund (dedicated funds) and $113,000,000 from federal funds. The request relates to changes following Senate Bill 1350 (2022) and methodology…