Medicaid Cost Allocation Changes

Governor, House and Final: Under the Affordable Care Act, responsibility for Modified Adjusted Gross Income Medicaid eligibility moves to the Health Benefit Exchange. The Department of Social and Health Services (DSHS) will receive less Medicaid revenue to support its administrative costs. In Fiscal Year 2014, a federal appropriation is provided to cover the DSHS administrative costs that will shift from Medicaid to the Supplemental Nutrition Assistance Program, the Temporary Assistance for Needy Families program, and the Refugee Cash Assistance program. An eligibility study, conducted by the Office of Financial Management, shall identify streamlined eligibility processes and potential revenue sources to address lost revenue for Fiscal Year 2015 and beyond.
Senate: The 2013-15 enacted budget reformed eligibility processes for the Medicaid program and transferred Medicaid eligibility work from Economic Services Administration (ESA) to the Health Benefit Exchange related to implementation of the Patient Protection and Affordable Care Act (ACA). This resulted in the loss of Medicaid funds at ESA without a reduction in eligibility workload for other public assistance programs. The 2013-15 enacted budget required the Office of Financial Management to conduct a study of the state’s medical and public assistance eligibility systems and infrastructure with the goal of simplifying procedures, improving customer service and reducing state expenditures. The report was due to the Legislature by January 1, 2014, but will not be completed until March 2014.