Staff flags Medicaid forecast increases and several proposed savings and benefit limits in SB 29/30

Staff presented a detailed Health and Human Resources briefing, saying most proposed HHR changes are forecast-driven while also identifying programmatic savings and policy changes within SB 29 and SB 30.

Mike (staff) said Medicaid forecast adjustments account for about $432,000,000 in total funds and the Children's Services Act (CSA) forecast increased by about $136,000,000. He listed a set of savings strategies the introduced budget proposes, including a $2,000 annual cap on adult dental benefits (adults only), limits on applied behavior analysis to 20 hours per week with an autism diagnosis requirement, and standardizing an hourly limit of 56 hours per week for certain long-term community-based personal care services with an exception process.

Mike also described proposed changes to the waiver and rate-study funding: the budget funds 7 of 11 rate-study services in the DD waiver (the other four are larger and would affect broader Medicaid services) and funds centralized call-center operations and other technical investments. He said one of the larger savings proposals would remove the automatic inflation adjustment for many Medicaid providers for the biennium, totaling about $238,000,000 in savings.

On HR 1 and Medicaid work requirements, staff said federal guidance remains incomplete and states face a rapid timeline to implement any work-requirement elements; staff noted some discretion remains but that many definitions are unresolved.

Committee members asked how reductions or caps would be implemented, how exceptions would be approved and whether federal matching funds would continue during implementation; staff repeatedly said guidance was still evolving and offered to follow up with additional detail.