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Financing

Coverage for the newly eligible adults will be fully funded by the federal government for three years, beginning in 2014, phasing down to 90% by 2020. Authorization for the Children's Health Insurance Program (CHIP) is extended through 2019 and funding is currently authorized through 2015. Additional federal funding for state Medicaid programs is also available for primary care, preventive care, community based long-term services and supports, and new demonstrations to improve quality and re-engineer delivery systems.

Areas of interest under this provision:

  • Federal Funding for Newly Eligible Medicaid and CHIP Enrollees and for certain adults in expansion states
  • Political Subdivisions
  • Federal Funding Opportunity for Emergency Psychiatric Demonstration Projects
  • Increased Federal Funding for Territories
  • Special Adjustment to FMAP Determination for Certain States Recovering from a Major Disaster

 

Federal Funding for Newly Eligible Medicaid and CHIP Enrollees and for certain adults in expansion states:

Most states that had previously expanded coverage for low-income adults will also receive an increased federal matching rate (which will phase up to 90 percent by 2020). Also offering states a choice of new approaches for how they can accurately access new federal funding for newly eligible individuals.

Political Subdivisions: Affecting the treatment of the political subdivision provision regarding an increase in the federal medical assistance percentage (FMAP) under the Recovery Act.

Federal Funding Opportunity for Emergency Psychiatric Demonstration Projects: The Medicaid Emergency Psychiatric Demonstration will provide up to $75 million over three years to 11 states—Alabama, California, Connecticut, Illinois, Maine, Maryland, Missouri, North Carolina, Rhode Island, Washington, and West Virginia—and the District of Columbia, to test whether Medicaid reimbursement to treat psychiatric emergencies in psychiatric hospital settings will enable states to increase the quality of care for people experiencing mental illness. The demonstration will also test whether such expanded coverage reduces cost and burden on general acute care hospital emergency departments. The Center for Medicare & Medicaid Innovation administers the demonstration, innovations.cms.gov/initiatives/medicaid-emergency-psychiatric-demo.

Increased Federal Funding for Territories: Providing increased federal funding to territories who do not elect to operate an Affordable Insurance Exchange. Appropriates $1 billion for 2014-19, with $925 million to be made available to Puerto Rico and $75 million for other territories.

Special Adjustment to FMAP Determination for Certain States Recovering from a Major Disaster: Reducing projected decreases in the FMAP for states that have experienced major, statewide disasters.