Matching pay rates to slow

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Lower Medicaid federal matching rates will be in place for about 30 states in fiscal 2014, according to a report from the National Association of Medicaid Directors. Just a handful of states will see an increase, the report predicted.

Extremely slow population growth from 2010 to 2011 is the reason for the unusual decrease in FMAP funding, experts note. Federal spending for Medicaid FMAPs in fiscal 2014 (which starts less than a year and a half from now) is expected to decrease by an amount ranging from $900 million to nearly twice that much, the report says.

Just an estimated four to seven states, meanwhile, will see an increase in FY 2014. Arizona, Florida, Nevada and Utah are among that group.

Medicaid pays for more than three-fifths of all nursing home care in the United States. On average, the federal government pays 57% of Medicaid's bills while states chip in for the other 43%.

Under the Affordable Care Act, there is a planned expansion of Medicaid services in most states, starting in January 2014. That could be influencing the projections, report author Vic Miller acknowledged.

The expansion “could cause financial and program disruptions,” he wrote.

As many as 16 million new enrollees could enter the Medicaid program due to the expansion.