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Human Services secretary outlines Medicaid enrollment, childcare funding and phased long‑term care rate change
Summary
Cynthia Pursley, Cabinet Secretary for the Department of Human Services, told the committee the Medicaid unwind is complete with enrollment near 512,000; she detailed childcare funding streams, prescription rebate gains, and a three‑year phase‑in for new long‑term care reimbursement rates.
Cynthia Pursley, cabinet secretary for the Department of Human Services (Speaker 12), answered lawmakers’ questions on Medicaid enrollment, childcare funding, prescription drug rebates and long‑term care reimbursement.
On Medicaid, Pursley said the unwind is complete and current August enrollment is roughly 512,000 covered lives (the department has previously reported a peak near 516,000). "We anticipated a little bit higher, and it was in fact at the end of the unwind about 516,000. But, 512 is our August enrollment," she said, and added the SFY2026 budget will be built on the post‑unwind average.
Pursley described childcare funding as a mix of state and federal sources: a state childcare development fund (~$2.2 million), a maintenance‑of‑effort line (~$5.6 million), anticipated TANF spending of about $41 million, a small social services block grant (~$96,000), and the Child Care Development Block Grant (about $75 million), yielding roughly $124 million in combined funding for SFY2025.
On prescription drug spending, Pursley attributed improved metrics to tighter formulary controls and rebate maximization; she said pharmacy rebates exceeded the budget by about $89 million. On long‑term care, she said new reimbursement rates will begin Oct. 1 after CMS approval of a state plan amendment and will phase in over three years (initial partial phase in year 1), producing estimated savings of about $60 million in year 1, $120 million in year 2 and $180 million in year 3.
Pursley also described the department’s work to implement outcome measures for residential SUD (substance use disorder) waiver programs and said data collection began July 1, with performance‑based reimbursement scheduled to start next year as written in the enabling legislation.
Lawmakers pressed for details on whether Medicaid savings free up other department lines; Pursley said transfers require legislative action and that the committee’s previous legislation established new measures the department is now implementing. No formal committee action was taken on the report.
