Michelle Bartlett, a licensed midwife and representative of the Idaho Midwifery Council, told JFAC that the state could save $130,000 per year by funding births attended by midwives, rather than in hospitals. That could be part of the solution, she said.

Robert Vande Merwe told lawmakers that Idaho's nursing homes are assessing themselves $10 million this year to help fund Medicaid, and they'll propose legislation to do so again next year. Nursing homes are expensive, he said, largely because of federal regulations. He also suggested that the state consider privatizing the Idaho State School & Hospital. "I think a private provider might be able to do it more efficiently and cost-effectively."

Marcie Granahan, CEO of the U.S. Psychiatric Rehabilitation Association, who traveled from Washington, D.C. to testify, told lawmakers that 5 percent of the population has a mental illness. "These individuals won't disappear if the funding does," she said, "When community-based psychiatric rehabilitation services are squeezed from the bottom, the individuals migrate ... to your state hospitals and your jails." Cutting funding for those services won't save the state money, she said. "On the contrary, Idaho will end up paying more."

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