Capitol Letters: Spotlight on Medicaid expansion cost


By Ryan Suppe, State Politics Reporter

The cost of Medicaid expansion is under scrutiny as lawmakers reconsider whether to continue the program.

Officials from the Idaho Department of Health and Welfare in recent weeks emphasized to lawmakers the benefits of Medicaid expansion, a state and federal partnership that subsidizes health care costs for low-income Americans who earn up to 138% the federal poverty limit.

About 140,000 Idahoans are enrolled in Medicaid under expanded eligibility. Most of the roughly $1 billion Medicaid expansion budget covers pharmacy expenses, such as drug costs, followed by hospital services that include preventative screenings, surgeries, COVID-19 hospital stays and emergency room visits.

“Without Medicaid expansion, participants who lose their coverage may experience gaps in care,” Idaho Department of Health and Welfare Medicaid Administrator Juliet Charron told lawmakers. “And this may be particularly challenging for individuals who are currently receiving care, such as cancer treatment.”

The Idaho Legislature appropriated more than $1 billion for Medicaid expansion for the first time this fiscal year, which started July 1. The Department of Health and Welfare is requesting a 3% increase next fiscal year.

In next year’s Medicaid expansion budget request, federal expenses are up about $25 million, to $803 million, compared to this year. The federal government covers 90% of Idaho’s Medicaid expansion costs.

The added costs of the Medicaid expansion would be covered by the increase in federal funding and state dedicated funds, Charron said.

The major factor driving those costs is an increase in supplemental payments to hospitals that participate in Medicaid, Charron said. That’s the result of a 2022 Idaho law directing more money to hospitals to cover the difference between Medicaid patients and patients covered by Medicare, the federal health insurance program.

Read my full story here.

Survey: Education still a top priority

Boise State University’s Idaho Policy Institute last week released the results of its annual survey, and education topped the list of Idahoans’ priorities once again.

But Idahoans appear more pessimistic about where the state is headed.

“The results of this year’s statewide survey show Idahoans are increasingly concerned about the future,” said Matthew May, the report co-author and survey research director for the School of Public Service. “Recognizing this rising concern and how Idahoans’ opinions on some issues have changed over time is useful as Idaho’s leaders and decision-makers evaluate policy options.”

Forty-four percent of Idahoans believe the state is heading in the right direction, while 41% believe it’s on the wrong track. Thirty-seven percent expect the state’s economy to worsen, and 36% expect it to stay the same.

Among legislative priorities, education retained the top spot from previous years. Jobs and the economy followed, while housing replaced health care as the third top priority from last year.

Read Reporter Mia Maldonado’s full story here.

What to expect today

  • Boise State University President Marlene Tromp and Idaho State University President Kevin Satterlee will discuss their schools’ budget with the Joint Finance-Appropriations Committee, starting at 8 a.m.

  • In the House Health and Welfare Committee, Rep. Charlie Shepherd, R-Pollock, will introduce legislation on protecting medical information for workers. The committee meets at 9 a.m.

  • Also at 9 a.m., the House Revenue and Taxation Committee will hear a presentation from Garden City Mayor John Evans on city budgeting.

  • The Senate Health and Welfare Committee will continue its discussion of Medicaid expansion. The committee meets at 3 p.m.

Catch up on last session

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