IGT/ Medicaid Trust Fund History
Governor Scott McCallum and Department of Health and Family Services (DHFS) Secretary Phyllis Dube announced on February 25th that all outstanding issues between the DHFS and the U.S. Department of Health and Human Services (DHHS), Centers for Medicare and Medicaid Services (CMS), have been resolved concerning Wisconsin’s claiming of federal Medicaid matching funds under the intergovernmental transfer program (IGT).
The resolution of these issues means the following for the State of Wisconsin:
Keep IGT Dollars in the Medicaid Trust Fund
Here’s why federal funds generated by IGT wire transfers now and in the future should remain in the Medicaid Trust Fund and be used to reimburse current and future nursing home services:
Nursing Home Financial Crisis
In addition to the aforementioned reasons why IGT federal funds should remain in the Medicaid Trust Fund, perhaps the most compelling reason is to address the severe financial crisis facing nursing homes today. Consider these facts:
IGT Medicaid Trust Fund - - Structural Deficit and Ongoing Funding Needs
The Medicaid Trust Fund was established to help the State address current and future nursing home needs. As noted above, those needs are significant and they aren’t going away. What may be of even greater concern is the perception that the recent IGT announcement creates a financial windfall for the State of Wisconsin. That perception ignores the reality of the IGT Medicaid Trust Fund’s future structural deficit. The truth is, under the best of circumstances, the Trust Fund’s projected closing balance will be in the red as of June 30, 2005. As shown by Table I, the projected fiscal condition of the Trust Fund for the 2005-2007 biennium is even bleaker. During that period, there will be a deficit ending balance in the Medicaid Trust Fund of $260.1 million in 2005-06 and that shortfall is projected to increase to $499.2 million by June 30, 2007.
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Table I |
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IGT Medicaid Trust Fund |
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Projected Balance (in millions) |
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Fiscal Year 2002 through 2007 |
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FY 2002 |
FY 2003 |
FY 2004 |
FY 2005 |
FY 2006 |
FY 2007 |
Opening Balance |
275.3 |
363.2 |
427.5 |
208.5 |
-22.8 |
-260.1 |
Closing Balance |
363.2 |
427.5 |
208.5 |
-22.8 |
-260.1 |
-499.2 |
Source: Division of Health Care Financing, Department of Health and Family Services
Table I figures do not reflect the cost of rate increases nursing homes most assuredly will require in future years to meet the needs of their residents and staff. If one assumes that nursing homes will be granted a modest 4% annual increase through the 2005-2007 biennium, the Trust Fund’s negative balance is even more startling. As shown by Table II, budgeting for a 4% annual nursing home rate increase results in a projected June 30, 2005 deficit of nearly $103 million, with the structural deficit reaching $659 million by the end of the 2005-07 biennium.
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Table II |
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IGT Medicaid Trust Fund |
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Projected Balance (in millions) |
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Fiscal Year 2002 through 2007 |
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FY 2002 |
FY 2003 |
FY 2004 |
FY 2005 |
FY 2006 |
FY 2007 |
Opening Balance |
275.3 |
363.2 |
427.5 |
168.5 |
-102.8 |
-380.1 |
Closing Balance |
363.2 |
427.5 |
168.5 |
-102.8 |
-380.1 |
-659.2 |
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Conclusion
What neither table reflects is how massive the Medicaid Trust Fund deficit will be in FY 2005 and beyond if Trust Fund dollars are used to help balance this budget reform bill and any future budgets. Will we be able to properly care for our elderly loved ones at that time if we have not planned for that care today?
The Wisconsin Association of Homes and Services for the Aging (WAHSA) is a statewide membership organization of not-for-profit corporations principally serving elderly and disabled persons. Membership is comprised of 197 religious, fraternal, private and governmental not-for-profit organizations which own, operate and/or sponsor 154 private and 47 county-operated nursing facilities, 65 community-based residential facilities, 32 residential care apartment complexes, 95 senior housing complexes, 26 facilities for the developmentally disabled, 10 licensed home health agencies, and over 300 community service agencies which offer programs ranging from Alzheimer’s support, child and adult day care, hospice and home care to Meals on Wheels. For more information, please contact the WAHSA staff at (608) 255-7060: John Sauer, Executive Director; Tom Ramsey, Director of Government Relations; or Brian Schoeneck, Financial Services Director.
February 27, 2002