One bright spot as far as funding in the Medicaid budget for next year: The federal matching rate for Idaho, known by the acronym FMAP, will rise from 70.23 percent to 71 percent on Oct. 1, 2012. That means the blended FMAP rate used for budgeting will rise from 69.86 percent in the fiscal 2012 budget to 70.81 percent in the fiscal 2013 budget. The result: A drop of $15.7 million in Idaho's general-fund spending requirement for Medicaid for fiscal 2013.

On the down side, hospital and nursing home assessments adding up to $36 million that helped boost Medicaid to avoid losing federal matching funds this year are sunsetting; Gov. Butch Otter is proposing replacing $20 million of that next year from an excess cash reserve at the Division of Veterans Services, and continuing the rest for one more year.