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October 12, 2017
Heather HowardLecturer in Public Affairs, Princeton University
Director, State Health and Value Strategies
The Future of Medicaid in NJ: An NJ Spotlight Roundtable
Agenda
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�Medicaid in NJ�Status of Affordable Care Act�Repeal and Replace�Other threats?
�Looking Ahead
Medicaid in New Jersey
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� 1 in 5 New Jerseyans enrolled
NOTE:FMAPpercentagesareroundedtothenearesttenthofapercentagepoint.TheseratesareineffectOct.1,2014-Sept.30,2015.TheseFMAPsreflectthestate’sregularFMAP;theydonotreflecttheFMAPfornewlyeligiblesinstatesthatadoptedtheACAMedicaidexpansion.SOURCE:FederalRegister,January21,2014(Vol.79,No.13),pp3385-3388,athttp://www.gpo.gov/fdsys/pkg/FR-2014-01-21/pdf/2014-00931.pdf.
MedicaidCostsareSharedbytheStatesandtheFederalGovernment
WA
OR
WY
UT
TX
SD
OK
ND
NM
NVNE
MT
LA
KS
ID
HI
COCA
ARAZ
AK
WI
WV VA
TNSC
OH
NCMO
MS
MN
MI
KY
IAINIL
GA
FL
AL
VT
PA
NY
NJ
NHMA
ME
DC
CT
DE
RI
MD
50.1-59.9 percent (13 states)50 percent (14 states)
60.0-66.9 percent (13 states)67.0-73.1 percent (11 states, including DC)
FFY 2015 FMAP
Medicaid Spending in NJ
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Medicaid spending in NJ
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Opioid Crisis
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� Prevalence in NJ
� NJ action� Increase provider rates� End silos
� Move Mental Health and Addiction Services to Department of Health� $200 million investment
� Trump administration lifted decades-old restriction on Medicaid payments for inpatient treatment at large residential facilities (IMD exclusion)
Repeal and Replace
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� Latest proposal (Graham-Cassidy) would have repealed many ACA provisions� Eliminate Medicaid expansion� Block grant bulk of federal health coverage spending� Redistribute funding among states, favoring low-spending states� NJ would lose $3.6 billion over six years
But it’s not over yet . . .
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Other threats?
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� Administrative undermining (sabotage?) of ACA� Cuts to outreach and enrollment� Impact of expected Executive Order on NJ consumer
protections?
� CHIP reauthorization� NJ slated to run out of funds in Spring 2018� End of enhanced matching rate?
� Federal budget proposals� Will tax reform proposals look to savings from health care?
Looking Ahead
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� Continued uncertainty of federal funding and policy direction� Impact on health care safety net and state budget� Promise of increased state flexibility (but with fewer
resources?)� New Governor’s approach to the dynamic policy
environment� Increasing recognition that Medicaid must account for social
determinants of health
Thank You!
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Heather HowardPrinceton University
[email protected]: @HeatherHHoward
www.statenetwork.org
