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 few 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 number of various applications.

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 applications, and have requested questions on how a lot the state has spent on hospitalizations, medication and different applications in current fiscal years.

“I first wish to simply say that my coronary heart is chilly. However I really feel like our accountability right here is to ensure the cash is nicely spent, in order that taxpayers can of preserving that cash and elevating their kids. So with that in thoughts, I haven’t got a chilly coronary heart however I do have a couple of questions.”

Prepare dinner and the remainder of the JFAC had so many questions that the division’s presentation ran towards 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 enlargement, which allowed working adults and the poor to acquire medical health insurance via Medicaid, at a lowered value to Idaho taxpayers.

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

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

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

Amongst its obligations, 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 kids 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 services to make sure they’re working safely and assembly all federal necessities
  • and directing a wide range of different applications resembling assist paying for youngster care, residential remedy services for youngsters, state psychiatric hospitals, grownup behavioral well being care, meals stamps, short-term money funds to low-income households, suicide prevention, public well being and extra.

The price range covers staffing prices to run these applications and pay for companies inside them.

The Medicaid price range request of $4.7 billion is about 16% increased than the fiscal yr 2023 appropriation, which was about 6% increased 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 through Idaho In Session)

In its presentation, the division confirmed that pharmaceuticals are Medicaid’s largest expense. Jepsen stated this was as a consequence of increased costs for “specialty medicines” and most cancers remedies.

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

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

Solely a small variety of Idaho residents may gain advantage from the drug — nevertheless it prices about $2 million a dose, he stated.

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

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