Day 1 of the Health and Care Budget Hearing: Medicaid and Child Care Costs and Federal Funds

The Idaho Division of Well being and Welfare makes up a couple of third of the state’s complete price range every year.

That is as a result of — as Director Dave Jepsen defined in a listening to Tuesday — the division serves an unlimited cross-section of the Idaho inhabitants, via a bunch of various packages.

Jepsen and different state well being and welfare officers answered questions from the Joint Appropriations Committee on Tuesday, throughout the first session of a multi-day listening to on the price range.

Idaho lawmakers have targeted on the big and rising prices of medical health insurance and Medicaid youngster care packages, and have requested questions on how a lot the state has spent on hospitalizations, medicine and different packages in current fiscal years.

“I first wish to simply say that my coronary heart is chilly. However I really feel like our duty right here is to verify the cash is effectively spent, in order that taxpayers can of protecting that cash and elevating their youngsters. So with that in thoughts, I haven’t got a chilly coronary heart however I do have just a few questions.”

Prepare dinner and the remainder of the JFAC had so many questions that the division’s presentation ran in opposition to its allotted time And it continues Wednesday.

Questions on federal funding for well being and welfare in Idaho

The 2022 election introduced extra far-right lawmakers into the Idaho Home and Senate, and some of these lawmakers have requested questions that recommend they wish to additional restrict Medicaid spending and roll again federally funded expenditures.

The majority of the division’s spending is a pass-through of federal authorities cash, versus Idaho’s personal cash. That is very true of the voter-approved Medicaid growth, which allowed working adults and the poor to acquire medical health insurance via Medicaid, at a diminished value to Idaho taxpayers.

“I am questioning,[with]our childcare packages… are we utilizing all of the federal cash?” requested Sen. Scott Herndon, R-Sagle. “Is It Doable to Run Youngster Care Applications Fully with State versus Federal Cash?”

Jill Randolph, a price range and coverage analyst at Well being and Welfare, instructed Herndon she could not say straight away if state cash might solely be used for childcare packages. However her presentation to the committee confirmed that previously few years, about 63% of the price range for these packages relied on federal funds.

What does the Idaho Well being and Care Plan do with a $5.5 billion price range?

Amongst its tasks, the Idaho Division of Well being and Welfare and its divisions and places of work are:

  • Administration of medical health insurance advantages for Greater than 434,000 youngsters and adults in Idaho via Medicaid and Youngsters’s Well being Insurance coverage Program, or CHIP
  • Operation of state youngster safety and custody methods
  • Examine healthcare amenities to make sure they’re working safely and assembly all federal necessities
  • and directing a wide range of different packages resembling assist paying for youngster care, residential remedy amenities for kids, state psychiatric hospitals, grownup behavioral well being care, meals stamps, momentary money funds to low-income households, suicide prevention, public well being and extra.

The price range covers staffing prices to run these packages and pay for providers inside them.

The Medicaid price range request of $4.7 billion is about 16% larger than the fiscal yr 2023 appropriation, which was about 6% larger than the fiscal yr 2022 appropriation.

Rep. Rod Furness, Rigby, famous the excessive value of Medicare for folks enrolled in Idaho Medicaid.

Idaho State Representative Rod Furness of Rigby sitting on the committee chair during a JFAC hearing
Rep. Rod Furness, R-Rigby, requested state well being and welfare officers about medical spending in his 2024 fiscal price range request. (Screenshot by way of Idaho In Session)

In its presentation, the division confirmed that prescribed drugs are Medicaid’s largest expense. Jepsen mentioned this was because of larger costs for “specialty medicines” and most cancers therapies.

“You might keep in mind that simply two years in the past, a remedy for hepatitis C was developed. The wonderful factor is that it is a remedy — hepatitis C can go away completely,” he mentioned. That was $300,000 per particular person for this drug. And so, you get these sorts of specialty medicine which are actually high-priced miracle medicine.”

Jepsen described a brand new drug remedy that “truly cures blindness in some folks, so here is the miracle: You can also make an individual see once more.”

Solely a small variety of Idaho residents may benefit from the drug — however it prices about $2 million a dose, he mentioned.

“It is oncology, most cancers medicine, and specialty medicine that drive up prices,” Jepsen mentioned. And the query stays open for us, how will we proceed to finest handle that. We have had conversations with colleagues in Medicaid packages throughout the nation. All of them face the identical downside.”

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