Two areas addressed in the House bill and supported by CWLA include the FMAP increase for state Medicaid and Title IV-E programs and an increase in funding of $9.6 billion for the Social Services Block Grant (SSBG).
The second COVID-19 bill increased each state’s Medicaid matching rate (FMAP—the federal medical assistance percentage) by 6.2 percent, but the governors have been seeking at least an increase by 12 percent making the match longer instead of having it stop at the end of the calendar quarter after the public health emergency is over. This bill increases the FMAP by 14 percent (meaning a state being matched at 50 percent would be matched at 64 percent). Under the House bill, that increase would start on July 1, 2020, and end June 30, 2021. The FMAP also extends to the Title IV-E programs of foster care, adoption assistance, and subsidized guardianships.
Reporting by Politico, as noted last week, shows how state Medicaid programs are being slammed. That report offered state examples of current Medicaid problems. In Georgia, which has been more aggressive in re-opening from the COVID-19 restrictions, Medicaid enrollment is projected to rise by as much as 567,000 people, Arizona in the past two months has experienced a 78,000 increase enrollment in Medicaid and the Children’s Health Insurance Program, New Mexico sign-ups in the first two weeks of April surged by about 10,000 more people, and in Michigan, officials indicate Medicaid enrollment could increase from 2.4 million to 2.8 million by the end of the year.
An analysis by the Kaiser Family Foundation released on Wednesday, May 13, 2020, indicates that because of the unemployment caused by the pandemic, “Among people who become uninsured after job loss, we estimate that nearly half (12.7 million) are eligible for Medicaid, and an additional 8.4 million are eligible for [ACA]marketplace subsidies, as of May 2020.”
The increased FMAP under Title IV-E will help states attempting to adjust rates for foster care, adoption assistance, and subsidized guardianships. Some states are using strategies such as temporary increases in foster care maintenance including adjusting or expanding medically fragile rates for foster parents who care for a child that has tested COVID-19 positive, assisting residential providers that may be dealing with COVID-19 outbreaks, providing higher rates as parents address issues such as becoming school teachers in the home—sometimes to children with learning disabilities. The IV-E FMAP increase is also useful for adoption assistance.
CWLA joined the Association of Administrators of the Interstate Compact on Adoption and Medical Assistance in sending a letter to the Children’s Bureau asking for guidance to states to encourage an increase for families that receive adoption assistance (see later article). The FMAP is particularly critical since not all children in care are covered by federal funding under Title IV-E, but state foster care rates extend across categories of families regardless of whether federal Title IV-E matches the funding or not.
The House bill also provides $9.6 billion for SSBG to be spent through the end of December 2021. An additional $850 million is also paid for through SSBG for child care needs for essential workers. The child care services through this fund are intended as more flexible in terms of income eligibility requirements and the forms of child care provided. The bill has an additional $7 billion for the child care block grant (CCDBG), but the child care community is still seeking a $50 billion total increase.
To address some SSBG critics that it is too broad, the $9.6 billion is targeted to disadvantaged communities and populations. The funding for the disadvantaged communities would take in a wide swath of the country based on the health and economic crisis that now exists.
The SSBG funding will be particularly important since it can be used in a range of services, including child welfare. It has been a key federal funding source in helping states address child protection and adult protective services, two important concerns during the pandemic.
For the first time, it extends funds to Tribal communities with the intention of providing $400 million of the $9.6 billion for Tribal communities and governments. Extending SSBG to Tribal communities is a priority for CWLA. The legislation also directs a pass-through of 50 percent of the funds to county and local governments that are required by their states to help match federal funds under Title IV programs, it also passes some of the money to other local governments working with community-based organizations and in some instances directly to community-based organizations.