Medicaid budget approved unanimously; $6.2M lower than governor’s proposal
The first vote that JFAC took this morning, on the budget for Medicaid for next year, was unanimous, 19-0, and there were no competing motions and no debate. The budget was developed by a working group that included Reps. Melissa Wintrow, D-Boise; Phylis King, D-Boise; and Luke Malek, R-Coeur d’Alene; and Sens. Steve Bair, R-Blackfoot; Mary Souza, R-Coeur d’Alene; and Abby Lee, R-Fruitland. “I think we all agreed and we’re comfortable with this one,” Souza said.
The budget that JFAC set reflects a 2.4 percent increase in state general funds, which is below the governor’s recommended 3.6 percent; and a 2.3 percent increase in total funds, below the governor’s recommended 3.3 percent. There are three reasons for the difference. First, the working group identified $5 million in general funds that it felt it could reduce that had been allocated for caseload growth. While Medicaid caseloads are increasing, the claims and overall costs aren’t increasing as fast as would otherwise be expected, because many of the increased patients are healthy children, for whom costs are relatively low. “What that amounts to is we found $5 million worth of general fund dollars,” Bair said.
The second difference is $1.18 million in general funds, $4.2 million in total funds, to comply with the Jeff D settlement by redesign of the state’s children’s mental health program. That item is awaiting passage of policy legislation to accomplish that change; once it passes, a “trailer” appropriation bill would follow from the Joint Finance-Appropriations Committee to add the funding. Bair said that bill is a must-pass item to comply with the longstanding lawsuit.
The third difference from the governor’s budget recommendation is that JFAC sliced out $50,400 in general funds, $100,700 in total funds, to add a financial manager position in Medicaid that the department had requested and the governor had approved funding.
The total budget JFAC set for Medicaid for next year is $531.9 million in state general funds, $2.285 billion in total funds; federal matching funds make up the majority of the funding for Idaho’s state-federal Medicaid program, which provides health care to disabled and low-income Idahoans.
JFAC also voted unanimously to set a budget for the Division of Welfare within the Department of Health & Welfare that’s slightly lower than the governor’s recommendation in state general funds, but identical in total funds. The difference comes because the legislative budget writers tapped $2.7 million from a Chip B fund balance that no longer was tabbed for any other use to sub in for $2.7 million in state general funds for a line item for the second phase of computer system upgrade for child support enforcement.
