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 whole price range annually.

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, 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 insurance and Medicaid little one care packages, and have requested questions on how a lot the state has spent on hospitalizations, medicine and different packages in latest 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 conserving 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 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 insurance via Medicaid, at a diminished price 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 Applications Totally with State versus Federal Cash?”

Jill Randolph, a price range and coverage analyst at Well being and Welfare, instructed Herndon she could not say immediately if state cash may 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 cash.

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 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 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 packages comparable to assist paying for little one care, residential remedy services 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% 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 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 attributable to increased costs for “specialty medicines” and most cancers remedies.

“You could do not forget 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 mentioned. 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 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 — 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 can 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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