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 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 way of a number of various applications.

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

Idaho lawmakers have centered on the massive and rising prices of medical insurance and Medicaid baby 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 need 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 holding that cash and elevating their youngsters. So with that in thoughts, I haven’t got a chilly coronary heart however I do have a number of 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 need 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 insurance by way of Medicaid, at a lowered 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 Potential to Run Little one Care Applications Totally with State versus Federal Cash?”

Jill Randolph, a finances and coverage analyst at Well being and Welfare, instructed 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 finances for these applications relied on federal cash.

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

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 youngsters and adults in Idaho by way of Medicaid and Youngsters’s Well being Insurance coverage Program, or CHIP
  • Operation of state baby 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 equivalent to assist paying for baby 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 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% greater than the fiscal yr 2023 appropriation, which was about 6% greater 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 because of greater costs for “specialty medicines” and most cancers remedies.

“It’s possible you’ll 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 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 “really cures blindness in some individuals, so here 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 — however 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 finest 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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