Thursday, March 28, 2024
Hawai'i Free Press

Current Articles | Archives

Thursday, September 28, 2017
US Senate Investigating Hawaii's Soaring Medicaid Costs
By News Release @ 11:08 PM :: 6625 Views :: Ethics, Hawaii Statistics, Health Care

Johnson Requests Data from CMS and State Governors on Medicaid Expansion’s Exploding Costs

News Release from US Senate Committee on Homeland Security and Governmental Affairs, September 27, 2017

WASHINGTON — U.S. Sen. Ron Johnson (R-Wis.), chairman of the Senate Homeland Security and Governmental Affairs Committee, sent letters Wednesday to the Centers for Medicare and Medicaid Services (CMS) Administrator and governors of eight states asking for information related to Medicaid expansion and the soaring costs that go far beyond initial projections.

“Federal Medicaid expenditures totaled $246 billion in fiscal year 2009, increased to $299 billion in fiscal year 2014 and are projected to rise 96 percent to $588 billion by 2025.  A primary cause of this increase is the ACA Medicaid expansion,” Johnson wrote in the letter. “Current CMS and other data show original Medicaid expansion per-enrollee spending and overall enrollment projections were significantly understated.  In 2014, CMS predicted per-enrollee spending on newly eligible adults in 2015 would be $4,281, but the actual amount was $6,365 (49 percent higher).  Accordingly, CMS increased per-enrollee projections for fiscal year 2023 from $5,076 to $7,027 (38 percent higher).”  

Similar letters were sent to the following state governors:

  *   *   *   *   *

Dear Governor Ige:   September 27, 2017

Medicaid policies and procedures.

Federal Medicaid expenditures totaled $246 billion in fiscal year 2009, increased to $299 billion in fiscal year 2014 and are projected to rise 96 percent to $588 billion by 2025. A primary cause of this increase is the ACA Medicaid expansion. Current data from the Centers for Medicare & Medicaid Services (CMS) and other sources show original Medicaid expansion per-enrollee spending and overall enrollment projections were significantly understated. In 2014, CMS predicted per-enrollee spending on newly eligible adults in 2015 would be $4,281, but the actual amount was $6,365 (49 percent higher). Accordingly, CMS increased per-enrollee projections for fiscal year 2023 from $5,076 to $7,027 (38 percent higher).

In many expansion states, enrollment and expenditures are rising swiftly. CMS data show that total costs for new Medicaid beneficiaries in Hawaii rose from $249.1 million in 2014 to $437.4 million in 2015-a 76 percent single-year increase. Costs per-enrollee jumped 73 percent in that same period, going from $7,462 in 2014 to $12,910 in 2015.

I am seeking to better understand these rising costs and higher-than-expected enrollment, especially in states where costs or enrollment are increasing especially quickly. Accordingly, I respectfully request that you please provide the following information and material:

1. Please provide the following data relating to Medicaid expansion in Hawaii:

a. Enrollment of VIII Group Newly Eligible Enrollees under the ACA Medicaid expansion for calendar year 2016;

b. Per-enrollee spending on newly eligible adults under the ACA Medicaid expansion for calendar year 2016;

c. Enrollment of VIII Group Newly Eligible Enrollees under the ACA Medicaid expansion for calendar year 2017 to date; and

d. Any quarterly reports for calendar year 2017 on enrollment figures and per enrollee spending.

2. Please explain why total costs for new Medicaid beneficiaries are rising so quickly in Hawaii and why per-enrollee costs under that expansion are rapidly increasing. Has Hawaii taken any steps to control these costs and, if so, what are those steps?

3. Please explain Hawaii's methodology for determining the eligibility thresholds for newly eligible enrollees under the ACA Medicaid expansion. Please also explain how Hawaii verifies that applications are accurate and that the enrollees qualify for the enhanced federal match rate for the expansion population.

4. Please explain whether Hawaii has commissioned or contemplated any audits to examine why the state's ACA Medicaid expansion costs are rising and whether any individuals have been misclassified as newly eligible. Please produce any such audits and all related documents and communications.

5. Please produce all documents and communications between or among employees or contractors of Hawaii referring or relating to the determination of eligibility for the "newly eligible" population under the ACA Medicaid expansion.

6. Please produce all documents and communications between or among employees or contractors of Hawaii and employees or contractors of insurance companies referring or relating to payment rates for insurance companies under the ACA Medicaid expansion.

I respectfully ask that you please provide this information as soon as possible, but no later than 5:00p.m. on October 11, 2017.

The Committee on Homeland Security and Governmental Affairs is authorized by Rule XXV of the Standing Rules of the Senate to investigate "the efficiency, economy, and effectiveness of all agencies and departments of the Government." Additionally, Rule XXV authorizes the Committee to study "the intergovernmental relationships between the United States and the States and municipalities."….

Sincerely,

Ron Johnson, Chairman

LINK: Footnotes

Ige Response Oct 11, 2017:

 

Related:

Coverage:

Links

TEXT "follow HawaiiFreePress" to 40404

Register to Vote

2aHawaii

808 Silent Majority

Aloha Pregnancy Care Center

AntiPlanner

Antonio Gramsci Reading List

A Place for Women in Waipio

Ballotpedia Hawaii

Broken Trust

Build More Hawaiian Homes Working Group

Christian Homeschoolers of Hawaii

Cliff Slater's Second Opinion

DVids Hawaii

FIRE

Fix Oahu!

Frontline: The Fixers

Genetic Literacy Project

Grassroot Institute

Habele.org

Hawaii Aquarium Fish Report

Hawaii Aviation Preservation Society

Hawaii Catholic TV

Hawaii Christian Coalition

Hawaii Cigar Association

Hawaii ConCon Info

Hawaii Debt Clock

Hawaii Defense Foundation

Hawaii Family Forum

Hawaii Farmers and Ranchers United

Hawaii Farmer's Daughter

Hawaii Federalist Society

Hawaii Federation of Republican Women

Hawaii History Blog

Hawaii Homeschool Association

Hawaii Jihadi Trial

Hawaii Legal News

Hawaii Legal Short-Term Rental Alliance

Hawaii Matters

Hawaii's Partnership for Appropriate & Compassionate Care

Hawaii Public Charter School Network

Hawaii Rifle Association

Hawaii Shippers Council

Hawaii Smokers Alliance

Hawaii State Data Lab

Hawaii Together

HIEC.Coop

HiFiCo

Hiram Fong Papers

Homeschool Legal Defense Hawaii

Honolulu Moms for Liberty

Honolulu Navy League

Honolulu Traffic

House Minority Blog

Imua TMT

Inouye-Kwock, NYT 1992

Inside the Nature Conservancy

Inverse Condemnation

Investigative Project on Terrorism

July 4 in Hawaii

Kakaako Cares

Keep Hawaii's Heroes

Land and Power in Hawaii

Legislative Committee Analysis Tool

Lessons in Firearm Education

Lingle Years

Managed Care Matters -- Hawaii

Malama Pregnancy Center of Maui

MentalIllnessPolicy.org

Military Home Educators' Network Oahu

Missile Defense Advocacy

MIS Veterans Hawaii

NAMI Hawaii

Natatorium.org

National Christian Foundation Hawaii

National Parents Org Hawaii

NFIB Hawaii News

No GMO Means No Aloha

Not Dead Yet, Hawaii

NRA-ILA Hawaii

Oahu Alternative Transport

Obookiah

OHA Lies

Opt Out Today

OurFutureHawaii.com

Patients Rights Council Hawaii

PEACE Hawaii

People vs Machine

Practical Policy Institute of Hawaii

Pritchett Cartoons

Pro-GMO Hawaii

P.U.E.O.

RailRipoff.com

Rental by Owner Awareness Assn

ReRoute the Rail

Research Institute for Hawaii USA

Rick Hamada Show

RJ Rummel

Robotics Organizing Committee

School Choice in Hawaii

SenatorFong.com

Sink the Jones Act

Statehood for Guam

Talking Tax

Tax Foundation of Hawaii

The Real Hanabusa

Time Out Honolulu

Trustee Akina KWO Columns

UCC Truths

US Tax Foundation Hawaii Info

VAREP Honolulu

Waagey.org

West Maui Taxpayers Association

What Natalie Thinks

Whole Life Hawaii

Yes2TMT