Idaho House passes state’s Medicaid budget, sending bill to governor

The Idaho Legislature this week approved an additional portion of Idaho Medicaid’s budget, sending the bill to Gov. Brad Little for final consideration.

Senate Bill 1201 would allocate nearly $674.2 million for Idaho Medicaid. Most of the funds — about $515.1 million — will come from the federal government, with the state’s general fund contributing $70.1 million.

The budget bill would fund a mix of largely administrative programs, including some that are required by the federal government or court order, along with a complex hospital tax structure.

The Idaho House passed the bill on a 40-30 vote Wednesday, two days after the Senate passed the bill on a 22-13 vote.

Idaho Medicaid is the state’s largest government program that offers health insurance assistance to roughly 351,000 Idahoans.

All told, Idaho’s total Medicaid budget for next fiscal year could be almost $5.25 billion, an 11.5% growth from this fiscal year.

Most of next year’s budget — $3.4 billion — is set to come from the federal government, which funds most regular Medicaid costs for Idaho and 90% of Medicaid expansion’s costs. The state’s general fund would contribute a little less than $1 billion to Idaho Medicaid’s total budget next year.

The 2026 fiscal year starts in July.

The bill also cuts $15.9 million in Medicaid expenses, anticipating that amount in savings from House Bill 345, a sweeping Medicaid policy reform bill Little signed that calls for work requirements, privatized Medicaid benefit management and more.

House debate rehashed worry over growing Medicaid budget, and angst over ‘enhancement’ budgets

For the past two years, Idaho’s powerful budget-setting committee has used a new practice of splitting state agencies budget bills in two categories.

So-called maintenance budgets just include enough funds for essential services. New spending is included in so-called enhancement budgets, like Senate Bill 1201.

Idaho’s budget committee, the Joint Finance-Appropriations Committee, crafted the budget bill March 21.

But “these are not new programs” they are “ongoing enhancements,” bill cosponsor Rep. Rod Furniss, R-Rigby, told House lawmakers in debate Wednesday.

“Many items on this budget … are expenses we’ve incurred. And we have an invoice for, that we need to pay,” Furniss told House lawmakers. “These are hospital stays. These are people in homes. These are infants with brain tumors. The list goes on and on — of people that we’re helping in the state of Idaho that can’t help themselves.”

The House’s debate, which lasted over half an hour, rehashed Republican Idaho lawmakers yearslong concerns over Idaho Medicaid’s growing budget. It also was another example of a newer trend this year — of state lawmakers trying to (with some success) reject state agency enhancement budgets.

Calling next year’s Medicaid total budget the largest Idaho has ever had, Rep. Faye Thompson, R-McCall, said she couldn’t vote for a budget of this size.

“This comes at a very great cost to the working man. And it comes at a very great cost to generations that follow us, and that also includes everybody in this room,” she said.