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 funds every year.

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

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

Idaho lawmakers have centered on the massive and rising prices of medical health insurance and Medicaid baby care packages, and have requested questions on how a lot the state has spent on hospitalizations, medication 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 nicely spent, in order that taxpayers can of retaining 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.”

Cook 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 counsel 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 lowered 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 Attainable to Run Youngster Care Packages Solely with State versus Federal Cash?”

Jill Randolph, a funds and coverage analyst at Well being and Welfare, informed Herndon she could not say instantly 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 funds for these packages relied on federal cash.

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

Amongst its duties, the Idaho Division of Well being and Welfare and its divisions and workplaces are:

  • Administration of medical health insurance advantages for Greater than 434,000 youngsters and adults in Idaho via Medicaid and Kids’s Well being Insurance coverage Program, or CHIP
  • Operation of state baby safety and custody programs
  • Examine healthcare amenities to make sure they’re working safely and assembly all federal necessities
  • and directing a wide range of different packages similar to assist paying for baby 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 funds covers staffing prices to run these packages and pay for providers inside them.

The Medicaid funds request of $4.7 billion is about 16% greater than the fiscal 12 months 2023 appropriation, which was about 6% greater than the fiscal 12 months 2022 appropriation.

Rep. Rod Furness, Rigby, famous the excessive value 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 funds request. (Screenshot by way of Idaho In Session)

In its presentation, the division confirmed that prescribed drugs are Medicaid’s largest expense. Jepsen stated this was resulting from greater 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 medication which are actually high-priced miracle medication.”

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

Solely a small variety of Idaho residents may benefit 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 packages throughout the nation. All of them face the identical drawback.”

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