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DSS projects $74.6M Medicaid shortfall; Community First Choice enrollment strains budget

Appropriations Committee · March 21, 2026
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Summary

The Department of Social Services told the committee it projects a $74.6 million net Medicaid deficiency driven by higher per-member costs, growth among seniors and people with disabilities (Husky C), higher pharmacy and home- and community-based service use and rapid Community First Choice enrollment growth. Commissioners said steps such as preferred-drug policies and OTC reforms have reduced some costs, but sustainability concerns remain.

Commissioner Andrea Barton Reeves told the Appropriations Committee the Department of Social Services projects a $74.6 million net deficiency in the Medicaid account for FY2026. Reeves attributed the shortfall primarily to higher per‑member utilization, growth in the Husky C eligibility group (seniors and people with disabilities), rising pharmacy costs and expanded use of home‑and‑community‑based services, including rapid enrollment in the Community First Choice (CFC) program.

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