U.S. Sen. Ron Johnson, R-Wis., seeks information from CMS and eight states related to "escalating" Medicaid costs.
In a letter to CMS Administrator Seema Verma, the senator says he wants to know why Medicaid spending exceeds initial projections.
"Federal Medicaid expenditures totaled $246 billion in fiscal year 2009, increased to $299 billion in fiscal year 2014 and are projected to rise 96 percent to $588 billion by 2025. A primary cause of this increase is the ACA Medicaid expansion," he wrote. "Current CMS and other data show original Medicaid expansion per-enrollee spending and overall enrollment projections were significantly understated. In 2014, CMS predicted per-enrollee spending on newly eligible adults in 2015 would be $4,281, but the actual amount was $6,365 (49 percent higher). Accordingly, CMS increased per-enrollee projections for fiscal year 2023 from $5,076 to $7,027 (38 percent higher)."
Sen. Johnson, who also is chairman of the Senate Homeland Security and Governmental Affairs Committee, also noted enrollment has "significantly" exceeded initial projects in many Medicaid expansion states, and that "costs per-enrollee are on the upswing in virtually every expansion state."
"The escalating costs to federal taxpayers could stem from the Medicaid expansion's reimbursement formula, which gives states a financial incentive to categorize people as newly eligible to obtain more federal money," he wrote. "I am seeking to better understand these rising costs, higher-than-expected enrollment and potential eligibility mistakes, especially in states where costs or enrollment are increasing especially quickly."
Sen. Johnson sent similar letters to governors of the following eight Medicaid expansion states: Hawaii, Michigan, Illinois, New Hampshire, New York, Ohio, West Virginia and California.
Read the full letter here.