OFB outlines FY26 public health budget; senators warn $14 million Medicaid match could be at risk
August 19, 2025 | Legislature 2025, Guam
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The Office of Finance and Budget (OFB) presented the Department of Public Health and Social Services' (DPHSS) proposed FY2026 funding levels to the Committee of the Whole and answered senators' questions about federal matching and carryover authority.
Director Guerrero told the committee that the department’s FY26 ceiling used FY25 appropriations as a baseline, raised local funds by about $1.7 million and increased the federal match by roughly $13.5 million; the net bottom-line increase for public health was described as 15.1 (million). Senators expressed concern that the budget does not include a full local match for Medicaid programs and warned that failing to provide a local match could forfeit up to $14 million in federal Medicaid funds.
Senators pressed for the Department of Administration (DOA) and BBMR to be present and questioned OFB’s decision not to include a specific local match item the department had reportedly requested. OFB said department officials had historically not maximized all federal grant opportunities and that, in its view, the lump-sum authorization in the department’s budget would permit managers to move local-match funds among programs to capture federal match increases. OFB also said the bill, as drafted, does not provide continuing-appropriation (carryover) language for public health but that the department had sought such authority at its budget hearing.
Several senators said they remained unconvinced that the administration’s approach would preserve the full federal match. One senator said losing $14 million in Medicaid would harm providers and Guam Memorial Hospital’s finances. OFB acknowledged the risk in general terms but pointed to managerial flexibility and historical patterns of not fully spending appropriations as reasons the administration proposed the status-quo approach rather than adding an explicit local-match appropriation.
Committee leadership said DPHSS has submitted amendments to the committee drive that would address continuing-appropriation concerns; the chair indicated those departmental amendments would be considered later in the session. No formal committee action on the public-health chapter was recorded in the transcript at the time the discussion concluded.
Director Guerrero told the committee that the department’s FY26 ceiling used FY25 appropriations as a baseline, raised local funds by about $1.7 million and increased the federal match by roughly $13.5 million; the net bottom-line increase for public health was described as 15.1 (million). Senators expressed concern that the budget does not include a full local match for Medicaid programs and warned that failing to provide a local match could forfeit up to $14 million in federal Medicaid funds.
Senators pressed for the Department of Administration (DOA) and BBMR to be present and questioned OFB’s decision not to include a specific local match item the department had reportedly requested. OFB said department officials had historically not maximized all federal grant opportunities and that, in its view, the lump-sum authorization in the department’s budget would permit managers to move local-match funds among programs to capture federal match increases. OFB also said the bill, as drafted, does not provide continuing-appropriation (carryover) language for public health but that the department had sought such authority at its budget hearing.
Several senators said they remained unconvinced that the administration’s approach would preserve the full federal match. One senator said losing $14 million in Medicaid would harm providers and Guam Memorial Hospital’s finances. OFB acknowledged the risk in general terms but pointed to managerial flexibility and historical patterns of not fully spending appropriations as reasons the administration proposed the status-quo approach rather than adding an explicit local-match appropriation.
Committee leadership said DPHSS has submitted amendments to the committee drive that would address continuing-appropriation concerns; the chair indicated those departmental amendments would be considered later in the session. No formal committee action on the public-health chapter was recorded in the transcript at the time the discussion concluded.
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