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 whole finances annually.

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, by 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 finances.

Idaho lawmakers have targeted on the massive and rising prices of medical insurance and Medicaid little one care applications, and have requested questions on how a lot the state has spent on hospitalizations, medicine and different applications in latest 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 ensure the cash is effectively spent, in order that taxpayers can of holding that cash and elevating their kids. 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 enlargement, which allowed working adults and the poor to acquire medical insurance by Medicaid, at a diminished price 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 Attainable to Run Youngster Care Applications Fully with State versus Federal Cash?”

Jill Randolph, a finances and coverage analyst at Well being and Welfare, instructed Herndon she could not say straight away 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 finances for these applications relied on federal funds.

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

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

  • Administration of medical insurance advantages for Greater than 434,000 kids and adults in Idaho by Medicaid and Kids’s Well being Insurance coverage Program, or CHIP
  • Operation of state little one safety and custody programs
  • Examine healthcare services to make sure they’re working safely and assembly all federal necessities
  • and directing a wide range of different applications akin to assist paying for little one care, residential therapy 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 finances covers staffing prices to run these applications and pay for providers inside them.

The Medicaid finances 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 price of Medicare for individuals 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 finances request. (Screenshot by way of 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 therapies.

“It’s possible you’ll keep in mind that simply two years in the past, a treatment for hepatitis C was developed. The wonderful 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 medicine which might be actually high-priced miracle medicine.”

Jepsen described a brand new drug therapy that “truly cures blindness in some individuals, so this is the miracle: You can also 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 medicine, and specialty medicine that drive up prices,” Jepsen stated. And the query stays open for us, how can 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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