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DCH briefs committee: Medicaid enrollment stabilizing after redeterminations; FMAP changes and PACE among FY26 priorities
Summary
DCH Commissioner Russell Carlson told the Appropriations Subcommittee that Medicaid enrollment is moving toward pre-PHE steady-state after redeterminations, highlighted PACE procurement and Katie Beckett caseworker additions, and said some savings resulted from favorable FMAP adjustments; he urged vigilance about federal policy changes.
Russell Carlson, commissioner of the Department of Community Health, told the House Appropriations Subcommittee on Health that the Medicaid program is operating and funded for current services while enrollment trends are returning to steady-state levels after pandemic-era redeterminations.
Carlson reviewed the governor's FY26 recommendations and described three items highlighted for committee consideration: stand-up and procurement work for the PACE (Program of All-Inclusive Care for the Elderly) initiative, additional caseworker support for the Katie Beckett program, and enrollment-driven growth estimates for core Medicaid populations. He said the department is benefits-heavy (about 97% programmatic spending) and that enrollment and utilization primarily drive cost projections.
On federal exposure, Carlson said DCH is "tracking the possibility of some changes" at the federal level but reiterated that "the Medicaid program itself is in a good position as far as delivering services here today." He told members DCH is modeling scenarios and engaging trade associations and federal contacts to monitor risks.
Notable details: - PACE procurement and consulting support were described as ongoing and expected to be competitive and targeted to larger service areas. - The Katie Beckett program has funding to add three caseworkers and some automation improvements; the commissioner described the positions as matchable hires. - Carlson said it received favorable FMAP adjustments that reduced state costs in specific lines and that growth estimates for FY26 were driven by updated enrollment projections.
Committee members asked whether redeterminations led to permanent loss of coverage; Carlson said enrollment fell from PHE peaks but that improved ex parte processes and automation increased timely case processing and that some reductions reflected genuine return to pre-PHE levels.
The commissioner asked the committee to consider the governor's funding priorities, pledged ongoing transparency about federal developments, and said DCH would provide further data to the committee on request.
