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Idaho Medicaid cuts may increase costs, opponents say

Hundreds line up to sign up to testify against proposed Medicaid cuts at the Idaho Legislature on Tuesday. (Betsy Russell)
Hundreds line up to sign up to testify against proposed Medicaid cuts at the Idaho Legislature on Tuesday. (Betsy Russell)

BOISE – Idaho’s plan to slash $120 million from its Medicaid program – including big cuts in services to the disabled – was roundly panned at a packed public hearing Tuesday, with disabled people, family members, providers and others all calling it unworkable and even cruel.

Becky Woodhead urged the House and Senate Health and Welfare committees not to pass the bill, House Bill 221, and cut the developmental disability services on which she relies. “It’s not right – I don’t agree to it,” she said.

Paul Tierney, whose 14-year-old son has autism, struggled to maintain composure as he urged lawmakers not to cut services that will help his son live independently as he grows older.

“Cutting Medicaid is not the answer to the budget problems of Idaho,” Tierney said. “If we can find money for a 5 percent increase for corrections, we should be able to find money … to keep them out of the correctional system.”

The House Health and Welfare Committee didn’t vote on the bill Tuesday, but plans to when it meets Thursday, although it first will seek clarification on several issues from Medicaid officials. Amendments to the bill are possible.

Two provisions that came in for the most criticism: Setting an age limit of 45 years, after which developmentally disabled people would lose access to developmental therapy and instead be moved to a state program that provides help for the aged and disabled; and booting higher-functioning developmentally disabled people off of therapy entirely. More than 1,000 disabled Idahoans stand to lose services under those two changes.

Numerous health care providers and advocates testified that the moves likely would increase costs to the state, not save millions as anticipated. People with intellectual disabilities who receive care in the community now under a waiver program must qualify for admission to an intermediate-care facility, attorney James Piotrowski told the committee, under both federal and state law. That means they’d move there if their waiver to receive the lower level of care in the community were removed.

Taryn Ivie, who said her adopted daughter’s intellectual ability will never exceed that of a 6-year-old, asked, “What will happen to my daughter when she reaches 45? We will be in our 70s. We will not be able to take care of her without help from some of the services.” She said, “I’m begging you to please look at this bill before you pass it through, and the people it will affect, and down the road what it will cost all of our taxpayers.”

The bill proposes 29 changes to Idaho’s Medicaid program, from halting mandatory rate hikes for Medicaid providers to reducing psychosocial rehabilitation services by 20 percent to slashing chiropractic services. It also calls for hospitals and nursing homes to pay millions in assessments to avoid further cuts, a move to which they’ve agreed.

Seventy-two people testified at the hearing that ran for nearly five hours Tuesday; just two of them spoke in favor of the bill.

Sen. Denton Darrington, R-Declo, told the crowd that every lawmaker on the committees has an extended family member or acquaintance with disabilities. “The only difference between you and us is we’re elected to make decisions,” he said, “and they are hard decisions to make.”