Medicaid reform gets solid House backing

BOISE – Reforms of the fast-growing Medicaid program won strong support from the state House on Tuesday, just after a budget was approved for the program for next year that counts on just a 7.8 percent increase – half as much as last year’s.

“There is a tie between this and the Medicaid reform,” Rep. Kathy Skippen, R-Emmett, told the Joint Finance-Appropriations Committee. “I think a lot of people are working very hard to try to make the system provide for those who need it.”

Gov. Dirk Kempthorne’s reform program counts on dividing the giant state-federal program that provides health coverage for the poor and disabled into three separate parts, each with its own rules and benefits. One would target healthy, low-income children and adults; another would be for seniors; and a third would be for the disabled.

“Some need the services and some don’t,” House Health and Welfare Chair Rep. Sharon Block, R-Idaho Falls, told the House. “This legislation is moving away from the traditional one size fits all.”

The House voted 56-11 to pass House Bill 776 after more than an hour of debate. The bill lays out the “framework” for the Medicaid reforms. Other pieces of legislation that follow will add specifics.

One of those passed ahead of the framework bill – HB 664, which allows disabled people to go to work without losing the Medicaid coverage that allows them to do so. It passed the Senate unanimously on Tuesday and headed to the governor’s desk. The measure allows disabled recipients to pay premiums on a sliding scale as their incomes increase, rather than lose their health coverage entirely.

That program, known as the “Medicaid buy-in” program, was among the pieces of legislation that Kempthorne touted as necessary reforms. The Medicaid budget that unanimously cleared the joint committee Tuesday includes full funding for the buy-in program and is designed to fit with the overall recommended reforms. Though the budget bill still needs approval from both houses and the governor’s signature, budget bills rarely are changed once set by the joint committee.

“Today’s action by the Legislature is a strong affirmation of the country’s single largest restructuring of the Medicaid program since its inception in 1965,” Kempthorne said in a statement.

The Medicaid budget bill calls for spending $25.8 million in state general funds next year and $57.6 million total.

That’s a 7.8 percent increase in state spending and a 4.8 percent increase in total spending, which includes the program’s federal funding.

State spending on Medicaid has risen an average of 12.5 percent a year in the past decade. Meanwhile, public school spending has risen an average of 4.4 percent a year, and the overall state budget has increased an average of 5.1 percent annually.

Medicaid accounts for just over 15 percent of the state budget, compared with 45.3 percent for schools.