Good news on Medicaid budget still pretty bad

Counting this year and adjustments to Gov. Kenny Guinn's proposed two-year budget, lawmakers may have to add more than $66 million to the Medicaid and other Human Resources budgets.

Charles Duarte, of Health Care Financing and Policy, asked the money committees to plan on a supplemental appropriation of $36.9 million to close out the current fiscal year budget.

And, he said, they should plan for additions to the proposed 2006-2007 budgets totaling another $30 million.

But the estimated increase to the current year's budget is largely in the backlog of bills to be paid and could be as low as $17.6 million by the time everything is totaled up, Duarte said.

"There's a big difference between $17 million and $36 million," said subcommittee Chair Sheila Leslie, D-Reno. "We can only hold these budgets so long. We need to know."

Duarte said Medicaid officials were working to produce hard numbers as fast as possible. He said the totals for this year's bills should be much better known by mid-May.

He said most of the additions are to catch up on payments owed primarily because costs per eligible participant have been higher than expected and processing of payments is running behind for Medicaid, the Division of Child and Family Services and University Medical Center.

In the proposed 2006-2007 budget, he said one issue is the reduction in the percentage of Medicaid the federal government is willing to support from 54.97 percent to 54.26 percent.

"That seems like a small amount but given the size of the budget, you're talking about millions," said Duarte.

The estimated general fund impact on Medicaid and Nevada Check Up is more than $4.3 million over the biennium.

The biggest change from the governor's recommended budget is still the so-called "clawback" - the estimated savings to Medicaid as those eligible are moved into Medicare. The original estimate was that would save Nevada $17.8 million. Guinn's staff built the budget using that estimate but later found out the savings would be far less.

Duarte said Wednesday the state will have to put $13.7 million back in the governor's proposed budget.

In addition, the average cost per eligible member increased $30 per month, which will cost the state $8.8 million in Medicaid.

In Nevada Check Up, caseload growth is driving the increases. That program was budgeted for a maximum of 30,000 children but is now projected at 429 more than that next year and 4,288 above that total in 2007. The cost is $3.1 million.

Altogether, the additions come to up to $36.9 million this year and $30 million for the coming two years.

n Contact reporter Geoff Dornan at gdornan@nevadaappeal.com or 687-8750.