Medicaid budget shows only small inrease

The Medicaid division of the state Department of Health & Welfare is among the biggest agency budgets that’s set by the Joint Finance-Appropriations Committee; it’s up today, on the final day of agency budget-setting.

Sens. Dan Schmidt, D-Moscow, and Steven Thayn, R-Emmett, worked together on the budget plan, which shows just a 0.7 percent increase in state general funds, and a 5.9 percent increase in federal funds. It reflects the latest interpretations of new requirements on Medicaid from the national Affordable Care Act; at the start of the legislative session, it appeared that the existing Medicaid caseload in Idaho would expand substantially as a result of mandatory changes in eligibility rules, but since then, new interpretations of those rules have come down showing no requirement to increase the eligible population. Those rules, called the MAGI or Modified Adjusted Gross Income changes, initially looked like they would shift large numbers of patients from the Children’s Health Insurance Program to Medicaid as well as bring in others, for a boost of 25,000 people in Medicaid, but that turned out not to be the case.

The budget includes $5 million in state general funds, and $12.4 million in federal funds, for anticipated increases in caseload coming from people who already are eligible for Medicaid, but haven’t enrolled, something federal agencies have called the “woodwork effect” It’s anticipated that with the new individual mandate requiring everyone to purchase insurance – and the fact that people won’t qualify for new subsidies to buy their health insurance if they’re found to qualify for Medicaid – more of those people will enroll.  The budget for Medicaid for next year totals $477.5 million in state general funds and $2.024 billion in total funds.

Sen. Sheryl Nuxoll, R-Cottonwood, said she can’t support the budget. “It is implementing the Affordable Care Act because of the individual mandate at a tremendous price,” she said.