Idaho will spend $78 million more if Medicaid expansion ends, state legislature official says

If voters hadn’t approved extending Idaho Medicaid to low-income adults, Idahoans would have spent tens of millions more on health care for these patients.

If the state withdraws its Medicaid coverage, Idahoans will spend nearly $78 million more due to the loss of federal funding, a state official told lawmakers Monday.

Idaho Medicaid is a state-run health insurance program. For decades, it was only offered to disabled adults, low-income children and, in some cases, their parents. When these Idahoans needed medical attention, the federal budget footed most of the bill – about 70% to 75% of it, depending on the year. The Idaho Medicaid budget paid for the rest.

What about other low-income adults in Idaho who couldn’t afford health insurance and didn’t qualify for Medicaid? When they needed medical care, the resulting medical bills often went unpaid — or, when paid, the money came from a hodgepodge of Idaho taxpayer-funded accounts. .

When Idahoans approved the expansion by a 60.6% vote in the 2018 election, he opened Medicaid to Idaho residents who were previously uninsured. Due to the provisions of the Affordable Care Act, the federal government promised to pay 90% of the medical bills for these newly insured patients.

Idaho lawmakers have for years chosen not to expand Medicaid. Still, federal law required Idahoans to contribute to the federal budget for the expansion.

The 2018 ballot measure opened the program to more people and changed the way health care was paid for in Idaho.

Today, approximately 145,000 Idahoans are covered by the Medicaid expansion.

“We know this eases the burden on the state and counties to support the indigent population, allows the state to remove the (catastrophic medical billing fund), and we are now able to claim federal matching for the behavioral health services that were previously provided by general state funds. It also supports a healthier workforce and supports lower health care costs and increased productivity,” said Juliet Charron, Idaho Medicaid Administrator, during her presentation to health committees. and welfare of the Idaho House and Senate.

Because there are more people insured by the program, and because of their medical needs and the cost of medical care, the Medicaid budget has increased significantly.

But, as Charron explained to members of the Idaho Legislative Assembly on Monday, Idaho taxpayers actually pay less for the medical care of these Idahoans. These patients would likely still go to the hospital or need surgery or cancer treatment without Medicaid; but now, she explained, their bills are 90% covered by federal funding, instead of being paid for by Idahoans taxes alone or not at all.

Idaho Rep. Megan Blanksma, R-Hammett, asks a question during a preview of Medicaid expansion.  She has brown hair and wears glasses and a gray blazer, raising her hand and pointing for emphasis
Idaho Rep. Megan Blanksma, R-Hammett, asks a question of Idaho Medicaid Administrator Juliet Charron during a joint meeting of the Idaho Legislature State Health and Wellness Committees . (Screenshot via Idaho in session)

Idaho hospitals have had to write off about $61 million less debt on unpaid bills since the Medicaid expansion, Charron said.

The committees met Monday for an overview of the first three years of the Idaho Medicaid expansion. The meeting was required by Idaho lawwhich directs lawmakers to “consider all fiscal, health and other impacts” of the expansion and to “make a recommendation” to the entire legislature on whether to proceed with the expansion.

Voters approved the expansion without buffets, but state lawmakers directed the Idaho Department of Health and Welfare to seek federal permission to add several buffets and conditions to the coverage of Medicaid. Almost all of those waiver requests failed to gain approval from the Trump and Biden administrations, Charron explained.

Dori Healey asks a question.  She is seated and dressed in blue
Rep. Dori Healey, R-Boise, asks a question during a preview of the Medicaid expansion Jan. 23. Healey, an advanced practice registered nurse, asked about preventive care and whether Medicaid recipients go to the emergency room instead of being referred to primary care. The settings. (Screenshot via Idaho in session)

Members of the Health and Wellness Committee peppered Charron with questions about the costs of the expansion, how it works to keep Idahoans healthy, and whether it really gives the people of Idaho health. idaho better access to care. In her responses to several questions, Charron said she would provide more information — as committees will continue to debate the expansion during this legislative session.

The biggest bucket of costs for Idaho Medicaid, and for the expansion group alone, has been pharmacy. This includes diabetes care, psoriasis and psychiatric medications, antiepileptic medications, and cancer treatments. As Dave Jeppesen, Director of Health and Welfare, explained to the Legislative Appropriations Committee last week, that’s mainly because of new, more expensive drugs.

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