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 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 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 funds.

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, medication and different packages in current 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 ensure the cash is properly spent, in order that taxpayers can of protecting 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.”

Cook 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 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 enlargement, 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 packages… are we utilizing all of the federal cash?” requested Sen. Scott Herndon, R-Sagle. “Is It Potential to Run Baby Care Packages Completely with State versus Federal Cash?”

Jill Randolph, a funds and coverage analyst at Well being and Welfare, informed Herndon she could not say straight away 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 funds.

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 insurance advantages for Greater than 434,000 kids and adults in Idaho by way of Medicaid and Kids’s Well being Insurance coverage Program, or CHIP
  • Operation of state little one safety and custody techniques
  • Examine healthcare services to make sure they’re working safely and assembly all federal necessities
  • and directing a wide range of different packages equivalent 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 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% larger than the fiscal 12 months 2023 appropriation, which was about 6% larger than the fiscal 12 months 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 funds request. (Screenshot through Idaho In Session)

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

“Chances are you’ll keep in mind that simply two years in the past, a remedy for hepatitis C was developed. The wonderful factor is that it is a remedy — hepatitis C can go away completely,” he mentioned. That was $300,000 per particular person 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 therapy that “really cures blindness in some folks, so here is the miracle: You can also 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 mentioned.

“It is oncology, most cancers medication, and specialty medication that drive up prices,” Jepsen mentioned. 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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