Estimated Adjusted Medicaid Funding Allocations Related to the Proposed American Recovery and Reinvestment Act
Gao ID: GAO-09-371R February 5, 2009Congress asked GAO to estimate the state allocations that would likely occur if an across-the-board percentage point increase in the Federal Medical Assistance Percentage (FMAP) replaced Section 5001 of the proposed American Recovery and Reinvestment Act of 2009, while maintaining the same funding level that the Congressional Budget Office estimated for this section. This correspondence responds to your request for state-by-state, quarter-by-quarter estimates of the Medicaid funding states would receive with such an across-the-board increase.
GAO-09-371R, Estimated Adjusted Medicaid Funding Allocations Related to the Proposed American Recovery and Reinvestment Act
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United States Government Accountability Office:
Washington, DC 20548:
February 5, 2009:
The Honorable Charles E. Grassley:
Ranking Member:
Committee on Finance:
United States Senate:
Subject: Estimated Adjusted Medicaid Funding Allocations Related to the
Proposed American Recovery and Reinvestment Act:
Dear Senator Grassley,
You asked us to estimate the state allocations that would likely occur
if an across-the-board percentage point increase in the Federal Medical
Assistance Percentage (FMAP) replaced Section 5001 of the proposed
American Recovery and Reinvestment Act of 2009, while maintaining the
same funding level that the Congressional Budget Office estimated for
this section.[Footnote 1] The following information responds to your
request for state-by-state, quarter-by-quarter estimates of the
Medicaid funding states would receive with such an across-the-board
increase.
To provide you with technical assistance, we developed an estimate of
state-by-state Medicaid allocations for the Recession Adjustment Period
defined in the proposed legislation. We used Medicaid data from the
Centers for Medicare & Medicaid Services (CMS) to estimate states'
funding allocations. States submit these data to CMS and they represent
states' anticipated Medicaid funding requirements for the current and
next fiscal year. These data may or may not correspond to future
Medicaid expenditures. See Enclosure 1 for estimates of each state's
approximate Medicaid allocation.
We are sending copies of this letter to interested congressional
committees. We will also make copies available to others upon request.
In addition, the letter will be available at no charge on GAO's Web
site at [hyperlink, http://www.gao.gov].
If you or your staff has any questions about this letter, please
contact Stanley J. Czerwinski, Director, Strategic Issues, who can be
reached at (202) 512-6806 or czerwinskis@gao.gov, or Thomas J. McCool,
Director, Center for Economics, who can be reached at (202) 512-2700 or
mccoolt@gao.gov.
Sincerely yours,
Signed by:
Stanley J. Czerwinski:
Director, Strategic Issues:
Signed by:
Thomas J. McCool:
Director, Center for Economics:
Enclosures:
[End of section]
Enclosure I:
Estimated Medicaid Assistance Projected to be Provided to States by
Replacing Section 5001 of the Proposed American Recovery and
Reinvestment Act with an Across-the-board FMAP Percentage Point
Increase (Dollars in Billions):
Alabama;
2009 Q1: $0.101;
2009 Q2: $0.101;
2009 Q3: $0.101;
2009 Q4: $0.101;
2010 Q1: $0.106;
2010 Q2: $0.106;
2010 Q3: $0.106;
2010 Q4: $0.106;
2011 Q1: $0.106;
Total for 9 quarters: $0.932.
Alaska;
2009 Q1: $0.032;
2009 Q2: $0.032;
2009 Q3: $0.032;
2009 Q4: $0.032;
2010 Q1: $0.030;
2010 Q2: $0.030;
2010 Q3: $0.030;
2010 Q4: $0.030;
2011 Q1: $0.030;
Total for 9 quarters: $0.278.
Arizona;
2009 Q1: $0.223;
2009 Q2: $0.223;
2009 Q3: $0.223;
2009 Q4: $0.223;
2010 Q1: $0.239;
2010 Q2: $0.239;
2010 Q3: $0.239;
2010 Q4: $0.239;
2011 Q1: $0.239;
Total for 9 quarters: $2.089.
Arkansas;
2009 Q1: $0.096;
2009 Q2: $0.096;
2009 Q3: $0.096;
2009 Q4: $0.096;
2010 Q1: $0.105;
2010 Q2: $0.105;
2010 Q3: $0.105;
2010 Q4: $0.105;
2011 Q1: $0.105;
Total for 9 quarters: $0.905.
California;
2009 Q1: $1.070;
2009 Q2: $1.070;
2009 Q3: $1.070;
2009 Q4: $1.070;
2010 Q1: $1.097;
2010 Q2: $1.097;
2010 Q3: $1.097;
2010 Q4: $1.097;
2011 Q1: $1.097;
Total for 9 quarters: $9.763.
Colorado;
2009 Q1: $0.090;
2009 Q2: $0.090;
2009 Q3: $0.090;
2009 Q4: $0.090;
2010 Q1: $0.092;
2010 Q2: $0.092;
2010 Q3: $0.092;
2010 Q4: $0.092;
2011 Q1: $0.092;
Total for 9 quarters: $0.819.
Connecticut;
2009 Q1: $0.132;
2009 Q2: $0.132;
2009 Q3: $0.132;
2009 Q4: $0.132;
2010 Q1: $0.133;
2010 Q2: $0.133;
2010 Q3: $0.133;
2010 Q4: $0.133;
2011 Q1: $0.133;
Total for 9 quarters: $1.194.
Delaware;
2009 Q1: $0.031;
2009 Q2: $0.031;
2009 Q3: $0.031;
2009 Q4: $0.031;
2010 Q1: $0.036;
2010 Q2: $0.036;
2010 Q3: $0.036;
2010 Q4: $0.036;
2011 Q1: $0.036;
Total for 9 quarters: $0.304.
District of Columbia;
2009 Q1: $0.039;
2009 Q2: $0.039;
2009 Q3: $0.039;
2009 Q4: $0.039;
2010 Q1: $0.040;
2010 Q2: $0.040;
2010 Q3: $0.040;
2010 Q4: $0.040;
2011 Q1: $0.040;
Total for 9 quarters: $0.359.
Florida;
2009 Q1: $0.457;
2009 Q2: $0.457;
2009 Q3: $0.457;
2009 Q4: $0.457;
2010 Q1: $0.466;
2010 Q2: $0.466;
2010 Q3: $0.466;
2010 Q4: $0.466;
2011 Q1: $0.466;
Total for 9 quarters: $4.160.
Georgia;
2009 Q1: $0.192;
2009 Q2: $0.192;
2009 Q3: $0.192;
2009 Q4: $0.192;
2010 Q1: $0.206;
2010 Q2: $0.206;
2010 Q3: $0.206;
2010 Q4: $0.206;
2011 Q1: $0.206;
Total for 9 quarters: $1.797.
Hawaii;
2009 Q1: $0.039;
2009 Q2: $0.039;
2009 Q3: $0.039;
2009 Q4: $0.039;
2010 Q1: $0.040;
2010 Q2: $0.040;
2010 Q3: $0.040;
2010 Q4: $0.040;
2011 Q1: $0.040;
Total for 9 quarters: $0.356.
Idaho;
2009 Q1: $0.034;
2009 Q2: $0.034;
2009 Q3: $0.034;
2009 Q4: $0.034;
2010 Q1: $0.039;
2010 Q2: $0.039;
2010 Q3: $0.039;
2010 Q4: $0.039;
2011 Q1: $0.039;
Total for 9 quarters: $0.329.
Illinois;
2009 Q1: $0.277;
2009 Q2: $0.277;
2009 Q3: $0.277;
2009 Q4: $0.277;
2010 Q1: $0.298;
2010 Q2: $0.298;
2010 Q3: $0.298;
2010 Q4: $0.298;
2011 Q1: $0.298;
Total for 9 quarters: $2.597.
Indiana;
2009 Q1: $0.160;
2009 Q2: $0.160;
2009 Q3: $0.160;
2009 Q4: $0.160;
2010 Q1: $0.172;
2010 Q2: $0.172;
2010 Q3: $0.172;
2010 Q4: $0.172;
2011 Q1: $0.172;
Total for 9 quarters: $1.502.
Iowa;
2009 Q1: $0.079;
2009 Q2: $0.079;
2009 Q3: $0.079;
2009 Q4: $0.079;
2010 Q1: $0.084;
2010 Q2: $0.084;
2010 Q3: $0.084;
2010 Q4: $0.084;
2011 Q1: $0.084;
Total for 9 quarters: $0.735.
Kansas;
2009 Q1: $0.060;
2009 Q2: $0.060;
2009 Q3: $0.060;
2009 Q4: $0.060;
2010 Q1: $0.060;
2010 Q2: $0.060;
2010 Q3: $0.060;
2010 Q4: $0.060;
2011 Q1: $0.060;
Total for 9 quarters: $0.541.
Kentucky;
2009 Q1: $0.132;
2009 Q2: $0.132;
2009 Q3: $0.132;
2009 Q4: $0.132;
2010 Q1: $0.133;
2010 Q2: $0.133;
2010 Q3: $0.133;
2010 Q4: $0.133;
2011 Q1: $0.133;
Total for 9 quarters: $1.193.
Louisiana;
2009 Q1: $0.163;
2009 Q2: $0.163;
2009 Q3: $0.163;
2009 Q4: $0.163;
2010 Q1: $0.250;
2010 Q2: $0.250;
2010 Q3: $0.250;
2010 Q4: $0.250;
2011 Q1: $0.250;
Total for 9 quarters: $1.900.
Maine;
2009 Q1: $0.058;
2009 Q2: $0.058;
2009 Q3: $0.058;
2009 Q4: $0.058;
2010 Q1: $0.056;
2010 Q2: $0.056;
2010 Q3: $0.056;
2010 Q4: $0.056;
2011 Q1: $0.056;
Total for 9 quarters: $0.513.
Maryland;
2009 Q1: $0.169;
2009 Q2: $0.169;
2009 Q3: $0.169;
2009 Q4: $0.169;
2010 Q1: $0.178;
2010 Q2: $0.178;
2010 Q3: $0.178;
2010 Q4: $0.178;
2011 Q1: $0.178;
Total for 9 quarters: $1.565.
Massachusetts;
2009 Q1: $0.332;
2009 Q2: $0.332;
2009 Q3: $0.332;
2009 Q4: $0.332;
2010 Q1: $0.312;
2010 Q2: $0.312;
2010 Q3: $0.312;
2010 Q4: $0.312;
2011 Q1: $0.312;
Total for 9 quarters: $2.885.
Michigan;
2009 Q1: $0.251;
2009 Q2: $0.251;
2009 Q3: $0.251;
2009 Q4: $0.251;
2010 Q1: $0.258;
2010 Q2: $0.258;
2010 Q3: $0.258;
2010 Q4: $0.258;
2011 Q1: $0.258;
Total for 9 quarters: $2.294.
Minnesota;
2009 Q1: $0.194;
2009 Q2: $0.194;
2009 Q3: $0.194;
2009 Q4: $0.194;
2010 Q1: $0.207;
2010 Q2: $0.207;
2010 Q3: $0.207;
2010 Q4: $0.207;
2011 Q1: $0.207;
Total for 9 quarters: $1.813.
Mississippi;
2009 Q1: $0.102;
2009 Q2: $0.102;
2009 Q3: $0.102;
2009 Q4: $0.102;
2010 Q1: $0.111;
2010 Q2: $0.111;
2010 Q3: $0.111;
2010 Q4: $0.111;
2011 Q1: $0.111;
Total for 9 quarters: $0.963.
Missouri;
2009 Q1: $0.181;
2009 Q2: $0.181;
2009 Q3: $0.181;
2009 Q4: $0.181;
2010 Q1: $0.197;
2010 Q2: $0.197;
2010 Q3: $0.197;
2010 Q4: $0.197;
2011 Q1: $0.197;
Total for 9 quarters: $1.706.
Montana;
2009 Q1: $0.023;
2009 Q2: $0.023;
2009 Q3: $0.023;
2009 Q4: $0.023;
2010 Q1: $0.025;
2010 Q2: $0.025;
2010 Q3: $0.025;
2010 Q4: $0.025;
2011 Q1: $0.025;
Total for 9 quarters: $0.214.
Nebraska;
2009 Q1: $0.042;
2009 Q2: $0.042;
2009 Q3: $0.042;
2009 Q4: $0.042;
2010 Q1: $0.044;
2010 Q2: $0.044;
2010 Q3: $0.044;
2010 Q4: $0.044;
2011 Q1: $0.044;
Total for 9 quarters: $0.389.
Nevada;
2009 Q1: $0.044;
2009 Q2: $0.044;
2009 Q3: $0.044;
2009 Q4: $0.044;
2010 Q1: $0.047;
2010 Q2: $0.047;
2010 Q3: $0.047;
2010 Q4: $0.047;
2011 Q1: $0.047;
Total for 9 quarters: $0.414.
New Hampshire;
2009 Q1: $0.030;
2009 Q2: $0.030;
2009 Q3: $0.030;
2009 Q4: $0.030;
2010 Q1: $0.033;
2010 Q2: $0.033;
2010 Q3: $0.033;
2010 Q4: $0.033;
2011 Q1: $0.033;
Total for 9 quarters: $0.282.
New Jersey;
2009 Q1: $0.219;
2009 Q2: $0.219;
2009 Q3: $0.219;
2009 Q4: $0.219;
2010 Q1: $0.237;
2010 Q2: $0.237;
2010 Q3: $0.237;
2010 Q4: $0.237;
2011 Q1: $0.237;
Total for 9 quarters: $2.060.
New Mexico;
2009 Q1: $0.084;
2009 Q2: $0.084;
2009 Q3: $0.084;
2009 Q4: $0.084;
2010 Q1: $0.089;
2010 Q2: $0.089;
2010 Q3: $0.089;
2010 Q4: $0.089;
2011 Q1: $0.089;
Total for 9 quarters: $0.781.
New York;
2009 Q1: $1.237;
2009 Q2: $1.237;
2009 Q3: $1.237;
2009 Q4: $1.237;
2010 Q1: $1.335;
2010 Q2: $1.335;
2010 Q3: $1.335;
2010 Q4: $1.335;
2011 Q1: $1.335;
Total for 9 quarters: $1.768.
North Carolina;
2009 Q1: $0.262;
2009 Q2: $0.262;
2009 Q3: $0.262;
2009 Q4: $0.262;
2010 Q1: $0.280;
2010 Q2: $0.280;
2010 Q3: $0.280;
2010 Q4: $0.280;
2011 Q1: $0.280;
Total for 9 quarters: $2.450.
North Dakota;
2009 Q1: $0.016;
2009 Q2: $0.016;
2009 Q3: $0.016;
2009 Q4: $0.016;
2010 Q1: $0.017;
2010 Q2: $0.017;
2010 Q3: $0.017;
2010 Q4: $0.017;
2011 Q1: $0.017;
Total for 9 quarters: $0.148.
Ohio;
2009 Q1: $0.345;
2009 Q2: $0.345;
2009 Q3: $0.345;
2009 Q4: $0.345;
2010 Q1: $0.359;
2010 Q2: $0.359;
2010 Q3: $0.359;
2010 Q4: $0.359;
2011 Q1: $0.359;
Total for 9 quarters: $3.175.
Oklahoma;
2009 Q1: $0.115;
2009 Q2: $0.115;
2009 Q3: $0.115;
2009 Q4: $0.115;
2010 Q1: $0.131;
2010 Q2: $0.131;
2010 Q3: $0.131;
2010 Q4: $0.131;
2011 Q1: $0.131;
Total for 9 quarters: $1.111.
Oregon;
2009 Q1: $0.093;
2009 Q2: $0.093;
2009 Q3: $0.093;
2009 Q4: $0.093;
2010 Q1: $0.095;
2010 Q2: $0.095;
2010 Q3: $0.095;
2010 Q4: $0.095;
2011 Q1: $0.095;
Total for 9 quarters: $0.844.
Pennsylvania;
2009 Q1: $0.433;
2009 Q2: $0.433;
2009 Q3: $0.433;
2009 Q4: $0.433;
2010 Q1: $0.456;
2010 Q2: $0.456;
2010 Q3: $0.456;
2010 Q4: $0.456;
2011 Q1: $0.456;
Total for 9 quarters: $4.011.
Rhode Island;
2009 Q1: $0.046;
2009 Q2: $0.046;
2009 Q3: $0.046;
2009 Q4: $0.046;
2010 Q1: $0.047;
2010 Q2: $0.047;
2010 Q3: $0.047;
2010 Q4: $0.047;
2011 Q1: $0.047;
Total for 9 quarters: $0.417.
South Carolina;
2009 Q1: $0.107;
2009 Q2: $0.107;
2009 Q3: $0.107;
2009 Q4: $0.107;
2010 Q1: $0.106;
2010 Q2: $0.106;
2010 Q3: $0.106;
2010 Q4: $0.106;
2011 Q1: $0.106;
Total for 9 quarters: $0.955.
South Dakota;
2009 Q1: $0.018;
2009 Q2: $0.018;
2009 Q3: $0.018;
2009 Q4: $0.018;
2010 Q1: $0.018;
2010 Q2: $0.018;
2010 Q3: $0.018;
2010 Q4: $0.018;
2011 Q1: $0.018;
Total for 9 quarters: $0.158.
Tennessee;
2009 Q1: $0.184;
2009 Q2: $0.184;
2009 Q3: $0.184;
2009 Q4: $0.184;
2010 Q1: $0.190;
2010 Q2: $0.190;
2010 Q3: $0.190;
2010 Q4: $0.190;
2011 Q1: $0.190;
Total for 9 quarters: $1.688.
Texas;
2009 Q1: $0.633;
2009 Q2: $0.633;
2009 Q3: $0.633;
2009 Q4: $0.633;
2010 Q1: $0.710;
2010 Q2: $0.710;
2010 Q3: $0.710;
2010 Q4: $0.710;
2011 Q1: $0.710;
Total for 9 quarters: $6.080.
Utah;
2009 Q1: $0.046;
2009 Q2: $0.046;
2009 Q3: $0.046;
2009 Q4: $0.046;
2010 Q1: $0.045;
2010 Q2: $0.045;
2010 Q3: $0.045;
2010 Q4: $0.045;
2011 Q1: $0.045;
Total for 9 quarters: $0.413.
Vermont;
2009 Q1: $0.029;
2009 Q2: $0.029;
2009 Q3: $0.029;
2009 Q4: $0.029;
2010 Q1: $0.033;
2010 Q2: $0.033;
2010 Q3: $0.033;
2010 Q4: $0.033;
2011 Q1: $0.033;
Total for 9 quarters: $0.282.
Virginia;
2009 Q1: $0.150;
2009 Q2: $0.150;
2009 Q3: $0.150;
2009 Q4: $0.150;
2010 Q1: $0.161;
2010 Q2: $0.161;
2010 Q3: $0.161;
2010 Q4: $0.161;
2011 Q1: $0.161;
Total for 9 quarters: $1.407.
Washington;
2009 Q1: $0.200;
2009 Q2: $0.200;
2009 Q3: $0.200;
2009 Q4: $0.200;
2010 Q1: $0.233;
2010 Q2: $0.233;
2010 Q3: $0.233;
2010 Q4: $0.233;
2011 Q1: $0.233;
Total for 9 quarters: $1.966.
West Virginia;
2009 Q1: $0.065;
2009 Q2: $0.065;
2009 Q3: $0.065;
2009 Q4: $0.065;
2010 Q1: $0.066;
2010 Q2: $0.066;
2010 Q3: $0.066;
2010 Q4: $0.066;
2011 Q1: $0.066;
Total for 9 quarters: $0.589.
Wisconsin;
2009 Q1: $0.150;
2009 Q2: $0.150;
2009 Q3: $0.150;
2009 Q4: $0.150;
2010 Q1: $0.154;
2010 Q2: $0.154;
2010 Q3: $0.154;
2010 Q4: $0.154;
2011 Q1: $0.154;
Total for 9 quarters: $1.370.
Wyoming;
2009 Q1: $0.013;
2009 Q2: $0.013;
2009 Q3: $0.013;
2009 Q4: $0.013;
2010 Q1: $0.015;
2010 Q2: $0.015;
2010 Q3: $0.015;
2010 Q4: $0.015;
2011 Q1: $0.015;
Total for 9 quarters: $0.130.
Total;
2009 Q1: $9.311;
2009 Q2: $9.311;
2009 Q3: $9.311;
2009 Q4: $9.311;
2010 Q1: $9.869;
2010 Q2: $9.869;
2010 Q3: $9.869;
2010 Q4: $9.869;
2011 Q1: $9.869;
Total for 9 quarters: $86.593.
Source: Data from Bureau of Labor Statistics (BLS), Centers for
Medicare & Medicaid Services (CMS), IHS Global Insight, and GAO
analysis.
Note: GAO calculations based on actual Federal Medical Assistance
Percentage (FMAP) rates for 2008 through 2010. Years shown are federal
fiscal years. Medicaid data are from the CMS Form 37. The CMS Form 37
is used to estimate federal Medicaid allocations. CMS Form 37 data are
not available for fiscal year 2011. We used CMS Form 37 data for the
fourth quarter of fiscal year 2010 as a proxy for the first quarter of
fiscal year 2011. Data for the territories are not included in this
analysis. We relied on the methodology outlined in our 2006 report on
strategies to help states address increased Medicaid expenditures
during economic downturns to guide the development of these estimates.
See GAO, Medicaid: Strategies to Help States Address Increased
Expenditures during Economic Downturns, GAO-07-97 (Washington, D.C.:
Oct. 18, 2006).
[End of table]
[End of enclosure]
Enclosure II: GAO Contacts and Staff Acknowledgments:
For information about this letter, please contact Stanley J.
Czerwinski, Director, Strategic Issues, who can be reached at (202) 512-
6806 or czerwinskis@gao.gov, or Thomas J. McCool, Director, Center for
Economics, at (202) 512-2700 or mccoolt@gao.gov. Contact points for our
Offices of Congressional Relations and Public Affairs may be found on
the last page of this letter. Individuals making key contributions to
this letter and related products include: Robert Dinkelmeyer, Greg
Dybalski, Susan J. Irving, Thomas James, Michelle Sager, Max Sawicky,
Michael Springer, and Carolyn L. Yocom.
[End of enclosure]
Footnote:
[1] CBO, Congressional Budget Office Cost Estimate, H.R. 1, American
Recovery and Reinvestment Act of 2009, An amendment in the nature of a
substitute, as introduced by Senators Inouye and Baucus on January 31,
2009 (Washington, D.C.: February 2, 2009).
[End of section]
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E-mail: fraudnet@gao.gov:
Automated answering system: (800) 424-5454 or (202) 512-7470:
Congressional Relations:
Ralph Dawn, Managing Director, dawnr@gao.gov:
(202) 512-4400:
U.S. Government Accountability Office:
441 G Street NW, Room 7125:
Washington, D.C. 20548:
Public Affairs:
Chuck Young, Managing Director, youngc1@gao.gov:
(202) 512-4800:
U.S. Government Accountability Office:
441 G Street NW, Room 7149:
Washington, D.C. 20548:
