This is part of a series of pieces the Detroit Free Press is doing on public issues in conjunction with PolitiFact, a nonprofit national news organization. Suggest a fact-check here.
With the crucial 2020 census running in the midst of a pandemic, many officials worry thmunities will lose out on billions of federal health care dollars allocated to states and localities based on census data.
Rep. Andy Levin, who represents Michigan’s 9th congressional district, took to Twitter to try to explain what’s at stake. “Every person who completes the #2020census brings nearly $1,000 for health care to their community. That means if 5% of Americans don’t get counted, we’ll lose $16.5 billion for local health care services,” he wrote.
After PolitiFact Michigan reached out to Rep. Levin’s office, the tweet was deleted and replaced with a new one focusing on Michigan.
“Every Michigander who completes the #2020census brings nearly $1,000 for health care to their community. That means if 5% of Michiganders don’t get counted, we’ll lose nearly $500 million for local health care services,” the revised tweet reads.
The correction illustrates the need to better understand how census data influences the distribution of federal funds to states and localities, particularly for health care amid the coronavirus crisis, which hit Michigan hard.
The federal government makes substantial contributions to Michigan’s Medicaid program, which provided health insurance for nearly one million residents in the last fiscal year. That number is expected to rise this year since economic downturns tend to result in higher Medicaid enrollment. Early analysis shows that the coronavirus has led to rising Medicaid enrollment across the U.S., likely due to the rise in unemployment and the loss of employer-provided insurance.
The first tweet stated that each American who is not counted by the census creates a $1,000 loss in federal funding for health care programs. But how much federal health care funding is attributable to each respondent depends on which state they live in. So the impact of a census undercount varies by state.
The deleted tweet also claimed that a national undercount would lead to a significant loss of federal funding for health care services. That’s not quite right. An undercount doesn’t eliminate the federal funding. It just means that it is allocated differently between places.
The funding for most federal programs that rely on census data is determined by appropriations passed by Congress. Congress agrees on how much money should be made available, and then census data help agencies determine how that money is allocated to states and localities.
“Funds lost in one state or area due to an undercount are not returned to the U.S. Treasury. They are distributed to all other states and areas,” writes Andrew Reamer, a research professor at George Washington University.
More: Detroit struggles while two tiny suburbs are nationwide census leaders
More: Despite pandemic chaos, Michigan has one of the highest census response rates in the country
Reamer looked at how an undercount would affect funding for several HHS grant programs that rely on census-derived data. These programs fund Medicaid, Medicare’s prescription drug coverage, the Children’s Health Insurance Program, foster care agencies, adoption assistance and the Child Care and Development Block Grant in each state.
Federal funding allocations to states for these programs are determined by a metric called the Federal Medical Assistance Percentage, which is calculated annually based on decennial census data and other factors.
A state’s FMAP indicates how much it will be reimbursed by the federal government for each dollar it spends. The higher the FMAP, the greater the federal reimbursement to the state. For instance, Michigan’s FMAP for the 2021 fiscal year is 64.08%, meaning the federal government contributes about 64% of the costs associated with these programs.
By statute, FMAPs can range from 50% to 83%. States with lower per capita incomes have a higher FMAP. Because a state’s per capita income is calculated by dividing its total income by its p…