HB 221, the bill to cut $39 million from Idaho's state Medicaid spending next year - giving up $81 million in federal matching funds as well, for a total cut in services of $120 million - is up for a public hearing tomorrow at 1:30 p.m., in the Capitol Auditorium, being held jointly by the House and Senate Health & Welfare committees. Strong opposition is anticipated to the proposed cuts; thousands have turned out at earlier hearings and at rallies across the state against cutting Medicaid services for disabled Idahoans.

The bill, co-sponsored by House Health & Welfare Chairwoman Janice McGeachin, R-Idaho Falls, and Senate Health & Welfare Chairwoman Patti Anne Lodge, R-Huston, makes a long list of cutbacks and changes, the largest of which include extending this year's temporary rule changes in Medicaid to save $6.9 million in state funds; ending statutory rate increases for providers to save $4.7 million in state funds; reducing psycho-social rehabilitation services for adults to four hours a week, to save $2.27 million in state funds; ending developmental therapy for hundreds of higher-functioning adults, to save $1.8 million in state funds; transitioning developmentally disabled adults over age 45 off developmental therapy; and more. One service, audiology benefits for adults, would be eliminated entirely, saving $70,000 in state funds.

The complicated bill is 25 pages long; you can read it here. The Idaho Association of Developmental Disabilities Agencies calls the proposed cuts "devastating." The group's president, Katherine Hansen, estimates that under the bill, 524 adults with developmental disabilities would lose all their community supports; 769 adults with developmental disabilities age 45 and older would no longer have access to skills training in their home or community; more than 700 people would lose their full-time jobs; and agencies throughout the state would would close their doors. "HB 221 dismantles the safety net for Idahoans with disabilities," Hansen said. Her group has gathered more than 17,000 Idahoans' signatures on petitions calling for keeping the services intact, even if it means raising taxes.

McGeachin, as she introduced the measure last week, said it's designed to reduce health care costs and ease the financial strain Medicaid puts on the state budget. But she said the proposal also would reform Idaho's Medicaid program, moving to more of a managed-care model and cutting out things that don't work. “We have an opportunity to reform the way we deliver these services,” she said.

House Minority Leader John Rusche, D-Lewiston, a physician, opposes the bill. He said, "I think it will cause deep and prolonged damage to the health care delivery system." He echoed concerns voiced by those at earlier hearings that cutting services will just lead to more-expensive care for the disabled, including institutionalization. "When it's all done," Rusche said, "we will have saved no money, and just passed up our federal match."