Quick Breakdown: Medicaid In the CNMI

Medicaid is a critical issue for the CNMI, and I will continue pushing for improvements that better serve our people. So for us to continue that conversation, it’s important you have some background on how the program works in the territories. Medicaid is a federal program that helps cover medical costs for low-income individuals—but unlike the states, where federal support is open-ended, territories like the CNMI operate under an annual funding cap. The federal government currently covers 83% of Medicaid costs, with the CNMI government responsible for the remaining 17%. However, once the CNMI hits its cap, it must pay 100% of all additional costs—often leading to service suspensions or delays in provider payments until the next fiscal year. While the cap increases each year based on medical inflation (CPI-U), it still falls short of meeting the growing cost of care and demand for services. This system creates serious challenges in providing stable, equitable healthcare—and it’s why Medicaid reform remains one of my top priorities in Congress.