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 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, by 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 big and rising prices of medical 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 need to simply say that my coronary heart is chilly. However I really feel like our accountability right here is to verify the cash is nicely spent, in order that taxpayers can of preserving 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.”

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 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 growth, which allowed working adults and the poor to acquire medical insurance by 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 Doable to Run Little one Care Applications Solely with State versus Federal Cash?”

Jill Randolph, a funds and coverage analyst at Well being and Welfare, advised Herndon she could not say instantly 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 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 tasks, 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 Medicaid and Youngsters’s Well being Insurance coverage Program, or CHIP
  • Operation of state baby safety and custody techniques
  • Examine healthcare services to make sure they’re working safely and assembly all federal necessities
  • and directing quite a lot of different packages reminiscent of assist paying for baby care, residential remedy services for kids, state psychiatric hospitals, grownup behavioral well being care, meals stamps, non permanent 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 yr 2023 appropriation, which was about 6% larger 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 funds request. (Screenshot through Idaho In Session)

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

“It’s possible you’ll do not forget 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 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 “truly 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 benefit from the drug — but it surely 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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