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Because the economy and the Medicaid program run counter cyclically or are negative correlated (when the economy falters, Medicaid enrollment increases ), to no one's surprise the COVID-19 pandemic's effect on the economy has put the Medicaid program in jeopardy. The US is experiencing the worst unemployment rate since the Great Depression causing state budgets, heavily reliant and income and sales taxes, to crater. (States, in sum, are looking at over $500 billion in revenue shortfalls between FY 2020 and FY 2022.) Simultaneously, Medicare enrollment is increasing, a Kaiser Family Foundation study found enrollment could increase by as much as 24 percent by this coming January, just as state funding for it dries up. All this explains why the Congress in March increased the federal government's Medicaid match or its funding share (termed FMAP) by 6%. The House in May, under its HEROES Act, increased the federal government's match to 14% and in addition appropriated more than $1 trillion to state and local governments, including $915 billion in flexible aid—which can be spent for any purpose. However, Senate Majority Leader Mitch McConnell failed to take up the HEROES Act. The president's executive actions this past Saturday, even if they prove legal, ignore the Medicaid program. For FY 2021, that began July 1 for 46 states, the aggregate revenue shortfall exceeds $300 billion.

This 27-minute interview begins with Dr. Molina's assessment of COVID-19 care under the Medicaid program and effects the pandemic is having on Medicaid and overall health care utilization. Dr. Molina moreover discusses the federal government's response to the pandemic, whether the federal government should fund a greater portion of Medicaid spending and, alternatively, the Trump administration's proposal to block grant federal Medicaid funding. He discusses state budget options to sustain adequate Medicaid funding. We conclude with Dr. Molina's work with United States of Care's, specifically its OpenSafely campaign.

Dr. J. Mario Molina is former CEO of Molina Healthcare that provides healthcare to low-income individuals, moreover Medicaid recipients and so called Medicaid-Medicare duals. He is also the former founding Dean of the Keck Graduate School of Medicine in Claremont, California. Currently, Dr. Molina work is focused on advocating for universal healthcare coverage and development next-generation medical technologies. His volunteer experience includes serving as Founders’ Council member of the United States of Care, board trustee for Johns Hopkins Medicine, Director for Homeboy Industries, Director for Aquarium of the Pacific, visiting committee member for Harvard Medical School, board of governors’ member for the Huntington Library and inaugural board member of the Financial Solvency Standards Board of the California Department of Managed Care. Dr. Molina is a Los Angeles native and graduate of Cal State Long Beach and the Keck School of Medicine at USC.

Information on United States of Care is at: https://unitedstatesofcare.org/.

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