HOUSE OF REPRESENTATIVES	H.C.R. NO.	147
TWENTY-FIFTH LEGISLATURE, 2009
STATE OF HAWAII

HOUSE CONCURRENT

RESOLUTION

REQUESTING AN INCREASE IN THE FEDERAL MEDICAL ASSISTANCE PERCENTAGE FOR HAWAII.

     WHEREAS, under the federal Medicaid program, the Secretary of Health and Human Services is statutorily required to pay each quarter to each participating state an amount equal to the federal medical assistance percentage (FMAP) of the total amount expended by the state during that quarter; and

     WHEREAS, the federal Medicaid statutes specify that each state's federal medical assistance percentage shall be determined annually by a formula that compares the state's average per capita income level with the national income average such that states with a higher per capita income level are reimbursed a smaller share of their costs; and

     WHEREAS, in technical terms, 42 United States Code section 1396d(b), specifies that the federal medical assistance percentage "for any State shall be 100 per centum less the State percentage; and the State percentage shall be that percentage which bears the same ratio to 45 per centum as the square of the per capita income of such State bears to the square of the per capita income of the continental United States (including Alaska) and Hawaii"; and

     WHEREAS, in less technical terms, the lesser the State percentage, the higher the federal medical assistance percentage; and

     WHEREAS, the Secretary of Health and Human Services is required annually to promulgate an FMAP for each state; and

     WHEREAS, the federal Medicaid statutes further specify that the federal medical assistance percentage cannot be lower than fifty per cent or higher than eighty-three per cent; and

     WHEREAS, in fiscal year 2004, the federal medical assistance percentages varied from 50 per cent in twelve states to 77.08 per cent in Mississippi, and averaged 60.2 per cent overall, while for Hawaii, the federal medical assistance percentage in fiscal year 2004 was 58.90 per cent, which was below the average of 60.2 per cent; and

     WHEREAS, likewise, it appears that in fiscal year 2005, the federal medical assistance percentages varied from 50 per cent in thirteen states to 77.08 per cent in Mississippi, and averaged 60.9 per cent overall, while for Hawaii the federal medical assistance percentage in fiscal year 2005 was 58.47 per cent, which again was below the average of 60.9 per cent; and

     WHEREAS, in fiscal year 2006, the federal medical assistance percentages varied from 50 per cent in thirteen states to 76 per cent in Mississippi, and averaged 60.2 per cent overall, while for Hawaii the federal medical assistance percentage in fiscal year 2006 was 58.81 per cent, which again was below the average of 60.2 per cent; and

     WHEREAS, for some states, the federal medical assistance percentages are or were set legislatively by Congress and not administratively by the Secretary of Health and Human Services; and

     WHEREAS, specifically, the Balanced Budget Act of 1997, Public Law No. 105-33, permanently raised the federal medical assistance percentage for the District of Columbia from 50 per cent to 70 per cent and raised the federal medical assistance percentage for Alaska from 50 per cent to 59.8 per cent through 2000, and the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000, Public Law No. 106-554, further adjusted Alaska's federal medical assistance percentage to a higher level for fiscal year 2001-2005; now, therefore,

     BE IT RESOLVED by the House of Representatives of the Twenty-fifth Legislature of the State of Hawaii, Regular Session of 2009, the Senate concurring, that the Congress is requested to legislatively increase the federal medical assistance percentage for Hawaii; and

     BE IT FURTHER RESOLVED that certified copies of this Concurrent Resolution be transmitted to the Speaker of the United States House of Representatives, the President and the Majority Leader of the United States Senate, and to the members of Hawaii's congressional delegation.

OFFERED BY:

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Report Title:

Federal Medical Assistance Percentage