Committee approves expansion of Idaho Medicaid budget

BOISE — The joint budget committee wrapped up a busy week Friday by approving a $3.1 billion budget for the Idaho Division of Medicaid for fiscal 2021.

That’s a whopping 10 percent, $283 million increase over the current year.

Federal funding accounts for 80 percent of that amount, or $229 million. State general fund support increased by $36.6 million, or 5.3 percent, to $724 million; dedicated funding, mostly in the form of hospital and nursing home assessments, increased by $17.5 million, or 6.9 percent.

Medicaid is the largest of the 100 or so individual agency budgets that the Legislature sets each year. It accounts for nearly a third of the total fiscal 2021 budget, as well as nearly 20 percent of projected general fund spending.

Much of next year’s spending increase is related to Medicaid expansion. Absent that, the overall budget increase would have been closer to 3 percent, or $87 million.

Idaho voters approved Medicaid expansion in 2018. The federal government will cover 90 percent of the cost. The state’s 10 percent match, which could be as much as $40 million per year, would be covered by a combination of agency savings and state tobacco settlement dollars.

A proposal to dock counties for 30 percent of the state cost, or about $12 million, is working its way through the Legislature.

That legislation, sponsored by Rep. Britt Raybould, R-Rexburg, also ends the county indigent program and state Catastrophic Health Program, which collectively have served as the “payer of last resort” to cover medical bills for Idahoans who can’t otherwise pay for the services.

The bill was held in the House Health and Welfare Committee after an hourlong hearing Friday. Members wanted more time to consider its implications; they indicated the Legislature likely won’t adjourn until this issue is resolved.

In other action Friday, the joint budget committee approved $2 million in emergency funding to address public health issues, including the coronavirus. The governor’s office said the money will likely be reimbursed by the federal government, since Congress approved an $8.3 billion aid package this week.

Spence may be contacted at bspence@lmtribune.com or (208) 791-9168.