AHS tells appropriations panel it needs $83.5M for Medicaid caseloads; outlines other BAA requests

Jenny Samuelson, secretary of the Vermont Agency of Human Services, told the House Appropriations Committee on Jan. 15 that the agency’s Budget Adjustment Act (BAA) testimony includes an $83.5 million gross increase for Medicaid caseload and utilization that requires $35.5 million in general‑fund matching dollars.

The request covers multiple categories the agency said are driven by caseload and utilization changes, settlement adjustments with the state’s accountable‑care organization (1Care), service‑level agreement billing, one‑time hospital cash‑flow needs tied to a shift to prospective/global budgets, and requests for limited extraordinary financial relief for certain residential mental‑health and substance‑use providers.

The nut graf: Medicaid spending and matching‑fund requirements account for the largest single pressures in this BAA submission, and agency officials said post‑pandemic redeterminations and higher utilization among current enrollees are the primary drivers.

Samuelson and Richard Donahay, chief financial officer for AHS, together walked the committee through headline numbers. Key highlights the agency cited included:

- Medicaid caseload and utilization: $83.5 million gross increase; $35.5 million general fund.

- Child Care Financial Assistance Program (CCFAP) consensus adjustment: a $13.1 million decrease in general fund…