Committee hears JAC explanation; tribal Medicaid shortfall estimate revised from $58M to $41M
Loading...
Summary
Joint Appropriations Committee staff told the Select Committee on Tribal Relations that an exception request for $58 million in spending authority was based on an overestimate; updated federal figures reduce the needed authority to about $41 million and JAC intends to accept the new estimate to grant spending authority to the executive branch and the Department of Health.
Representative Bair, chairing the Joint Appropriations Committee’s presentation to the Select Committee on Tribal Relations, told the panel that an exception request for $58 million in additional spending authority was rejected but has since been recalculated based on newly released federal numbers.
Bair said the program has been funded via a federal reimbursement model since 1995 and is reimbursed at 100% for Medicaid‑related services provided on the reservation. He explained that the biennial base budget for the program is $92 million and that actual expenditures in the last biennium exceeded that baseline. The department initially estimated a 10% rate change — yielding the $58 million figure — but the federal increase was later published at 3.12%. That change reduces the additional spending authority needed to about $41 million, Bair said.
"This is really an accounting issue," Bair told the committee, adding that, without pre‑approved spending authority, the chief executive could still use a B‑11 notification to the legislature to obligate and later obtain federal reimbursement, as has happened historically. He said the Joint Appropriations Committee is likely to act to accept the revised estimate and grant the spending authority to the governor and the department prior to the upcoming session.
Senator Salazar and other committee members signaled support for accepting the department’s revised figure. "I’m very confident that the state senate will fully support whatever the Department of Health number is," Salazar said. Another senator noted a prior 9–3 vote in committee and thanked JAC chairs for restoring funding to the budget.
Why it matters: health providers serving Wind River Reservation and surrounding communities told the committee that Medicaid revenue is the foundation of clinic operations and of investments in transport, specialty referrals and preventive programming. Witnesses repeatedly warned that inadequate funding places services and, by their account, patient lives at risk.
What’s next: committee members requested the Department of Health memorandum that produced the revised estimate; Bair and other committee chairs pledged to provide that document. The Joint Appropriations Committee indicated it will proceed to accept the federal estimate and adjust spending authority accordingly before the legislative session.
