Nevada Legislature raises Medicaid, checkup budgets by $1.2 billion

Legislative money committees on Friday approved Medicaid/Nevada Check Up program budgets that total $9 billion over the coming two-year budget cycle.

That’s $1.2 billion more than the current budget, an increase of 14.9 percent. That includes $8.79 billion in federal funds and $1.77 billion in state General Fund money.

Medicaid consumes $8.5 billion of that total to provide health coverage for low-income persons. Check Up is the companion program that provides healthcare for low-income children budgeted at $125.7 million over the biennium and $344.6 million in the Health Care Financing and Policy budget.

The biggest reason for the increase is the reduction in the percentage of total costs paid by the federal government. That percentage, known as FMAP, is projected to decrease from 65.09 percent to 64.17 percent in 2020 and 63.74 percent in 2021. Nevada’s share of that change will be $19 million.

For the newly eligible Medicaid enrollees under Obamacare, the FMAP remains at 90 percent.

FMAP is adjusted by the federal government every year based on the relative wealth of the different states. Nevada’s economy has been booming compared to the rest of the nation, driving FMAP down.

The other driver is the Medicaid caseload. That number has actually decreased since last September by about 12,675 to 643,992, about 20 percent of Nevada residents. Enrollment is expected to further decrease in 2020 and 2021 to 640,083 by the end of the biennium.

The budget includes $48.7 million to expand services in a variety of areas including supportive living arrangements, neonatal care rising pharmaceutical costs, pediatric care and added behavioral health clinics and homelessness services.

Medicaid is the largest budget in state government, but the majority of the money comes from the federal government.

It also includes mandatory increases in reimbursement rates for managed care, dental services and drug costs.