Expanded health coverage bill could face funding gap – The Guam Daily Post

While the expanded health care coverage plan introduced in Bill 132-34 could potentially insure thousands, the program could also run into a funding chasm with its proposal to use the Patient Protection and Affordable Care Act.

The U.S. House of Representatives has repealed the Patient Protection and Affordable Care Act, also known as Obamacare, while the Senate has yet to take action on the legislation.

Sen. Dennis G. Rodriguez Jr. recently introduced 10 bills that would allow sweeping changes to the health care system in Guam, including Bill 132-34 or The Health Care Para Todu Plan. A press conference was held at Rodriguez’s office in Tamuning yesterday morning to discuss the new bills.

Rodriguez had indicated in the proposal that 55 percent of the total insurance cost would be shouldered by federal sources, meaning Obamacare. Under the Para Todu Plan, employers pay 65 percent of the remaining portion. For example, for a $4,500 health insurance cost, the federal and employer contribution is at $2,475 and $1,316, respectively.

According to the Health Insurance Expansion Program proposal, Obamacare provided around “$268 million in Medicaid funding for Guam for the period from July 1, 2011, to Sept. 30, 2019.” Rodriguez said around $170 million remains from the proposed funding source.

Under the plan, low-income individuals and employees of small businesses will be provided access to insurance. These sectors comprise those who are between 108 percent to 200 percent of the Guam-adjusted federal poverty level, which could potentially extend coverage to around 15,000 to 16,000 individuals. The plan also introduces subsidy options for these two population sectors to make coverage more affordable.

“We know that (the House) has repealed Obamacare. (The) Senate is looking at the same thing,” Rodriguez acknowledged, but he holds hope the remaining $170 million would remain available to Guam even when Obamacare gets replaced.

“What is interesting is, in those measures today, Guam is not part of it, not part of it again. This sets us up to be able to come into the table that we have a plan. This is what it would look like to be able to provide services to our community,” he said.

Public Health Director James Gillan said he’s still reviewing the various health care proposals from Rodriguez.

However, Gillan said the $168 million that remains available to Guam, under Obamacare, could go away once Obamacare is repealed. And the local government could have used that remaining amount, but there’s a lack of local funding to match it, he said.

Guam has approximately 32,465 uninsured residents, or 21 percent of the island’s population, according to the Guam Statistical Yearbook.

Cash-flow challenges

Rodriguez also introduced Bill 133 or the Mañaina Yan Mañe’lu Island Community Health Plan of 2017. Under the proposed plan, the locally funded Medically Indigent Program will change from being run by the Department of Public Health and Social Services to what the legislation called a “commercially managed program.”

The proposed shift means instead of the government paying for the medical bills of indigent patients, a commercial health plan provider would cut the check to the hospitals and clinics.

MIP took effect in 1984 to pay for hospital care and clinic services to patients who are indigent, and whose household income falls within the federal poverty line. The MIP had more than 11,000 participants and a budget appropriation from the government of Guam coffers of $13.1 million in the previous year.

There will be three categories under this commercially managed plan, and one – Mañelu Plus – allows the Federated States of Micronesia government to contribute to the program some of the funds it receives from the U.S. government. The plan to get the FSM government involved in the health care of its citizens on the island could pose challenges, as GovGuam tried something similar years ago, Gillan said.

The idea to get the FSM involved requires commitment from the FSM to provide the money – perhaps through a revolving fund that the FSM must continue to keep on replenishing for it to work, Gillan said. However, it’s unclear if the FSM can keep up with that kind of commitment over the long term, he added.

Bill 133 is a complex measure with meaningful impacts to the future of indigent medical care on Guam,” said Speaker Benjamin Cruz.

“At present, the government of Guam is already in a commercial relationship with three of the island’s four insurers, yet we are behind millions of dollars in health insurance premiums for our retirees and active employees. Because a ‘commercially managed MIP’ is still subject to our cash-flow challenges, what happens when we cannot pay?” Cruz asked.

Source: Google News :

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