Delaware's Department of Health and Social Services is asking state budget officials for $42 million in additional funding to pay for Medicaid and other programs.
The $1.22 billion budget request presented Tuesday represents an increase of 3.6 percent over the current year's budget. It includes $13.3 million for Medicaid, which currently covers some 220,000 people, more than one-fifth of Delaware's population.
Officials are also seeking $4.7 million in additional funding for developmental disabilities programs, $2.8 million to support growth in child care programs, and $2 million more for substance abuse programs.
Meanwhile, officials are warning that a repeal of the Affordable Care Act under the Trump administration would have a significant impact on Delaware's Medicaid program, with a possible cost shift to the state of more than $100 million annually.
DHSS Secretary Rita Landgraf said she was pleased that president-elect Donald Trump has appeared to show a willingness to consider the benefits of some aspects of the ACA, such as helping ensure coverage for people with pre-existing conditions and allowing people under 26 to remain on a parent's insurance plan.
"I was somewhat pleased that the rhetoric around that during the election was kind of dialed back,'' she said. "My hope is that both Congress and president-elect Trump will look at any unintended consequences relative to any changes to the ACA.''
Landgraf is particularly concerned about any changes related to Delaware's decision to expand eligibility for its Medicaid program from 100 percent to 138 percent of the federal poverty level. The change added close to 10,000 people to Delaware's Medicaid program and resulted in the federal government paying a higher share of the costs for people on Medicaid.
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If that higher cost share were to go away, the state would be facing "a $100 million issue'' that would have a ripple effect across the health care system, affecting providers as well, Landgraf said.
In the meantime, Landgraf, who is leaving state government to take a job at the University of Delaware next year, said behavioral health, including programs for the mentally ill and those battling substance abuse, should be a top priority for the state.
At an earlier hearing Tuesday, state economic development director Bernice Whaley presented a general fund request of $3 million for the fiscal 2018 operating budget, up from $2.9 million this year. She also submitted a capital budget request of $41.5 million, up from $33.6 million. The request includes $15 million to recapitalize the state's strategic fund, which provides incentives to businesses to try to attract and retain jobs, and $16 million for the port of Wilmington.
