MACPAC Discusses Medicaid Financing, DSH, and the Unwinding of Continuous Coverage

The Medicaid and CHIP Payment and Access Commission (MACPAC) met on Dec. 14 and 15 to discuss issues including barriers to improving the transparency of Medicaid financing, disproportionate share hospital (DSH) allotment, and the unwinding of Medicaid continuous coverage. 

The MACPAC session on Medicaid financing highlighted the commission’s prior work and recommendations as well as examined findings from expert interviews. These interviews highlighted the following barriers to improving the transparency of Medicaid financing: unclear goals of additional transparency, incomplete information about state-level methods and amounts, multiple approaches that could be used to collect provider-level financing amounts, and challenges with using provider-level financing amounts to calculate net payments. MACPAC plans to include a chapter on Medicaid financing in their June 2024 report to Congress.  

The commission then went on to review their annual analysis of Medicaid DSH allotments to states. MACPAC estimated that fiscal year 2024 DSH allotments will be reduced by 51% ($8 billion) on Jan. 20, 2024, due to scheduled reductions unless congressional action is taken. The commission plans to include a chapter on Medicaid DSH in their March 2024 report to Congress.  

Lastly, the commission revisited the Medicaid unwinding of continuous coverage. Specifically, the commission reviewed data related to national and state renewal outcomes, enrollment changes, and operations data related to call center statistics and applications.