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Budget panel presses FSSA on Medicaid forecast, ABA changes and pathways waiver costs
Summary
Committee members pressed Family and Social Services Administration presenters for detailed splits of federal versus state funding, a cost estimate for eliminating the pathways waiver and clarification of recent ABA rate and hours changes that reduced spending.
Family and Social Services Administration presenters faced detailed questioning from the State Budget Committee on Dec. 16–17 about Medicaid forecasting, Applied Behavior Analysis (ABA) provider rules and the pathways waiver.
Dan Rusyniak and later Cora Steinmetz and Jeremy Palmer told the committee that a $2.5 billion figure under a designated funding line (DFR) is a mix of federal and state dollars; Senator Fady Qaddoura repeatedly asked for a clear report on how that total is split and for a cross-agency estimate of the cost of eliminating the pathways waiver. Rusyniak and FSSA staff said they would provide detailed reports on funding splits and on the State match for the Child Care and Development Fund (CCDF).
Committee members also focused on ABA services. Steinmetz described recent changes in provider requirements and rate-setting that are expected to reduce ABA spending, including a cap reducing weekly hours for some individuals and new rate structures that did not exist before Jan. 1, 2024. Steinmetz said those changes produced significant cost savings for the agency. Ms. Steinmetz also noted recommended background checks and licensure steps described in an OIG bulletin.
On Medicaid forecasting, Jeremy Palmer and other presenters said Indiana retained more enrollees following the federal Medicaid unwind than many states and that Indiana’s unwind took a full 12 months. Palmer characterized an estimated forecasting error as “around $1 million,” noting he was guessing at the figure. Senator Ryan Mishler and Representative Ed DeLaney pressed whether Indiana’s forecast methodology and assumptions led to the variance and asked for clearer documentation going forward.
The committee requested written reports and data on federal vs. state funding shares, pathways waiver cost estimates, CCDF state match figures and details about ABA licensure and rate changes. No formal appropriation or policy action was taken during the hearing; presenters said they would provide the requested documentation to the committee.
