BOISE, Idaho — The Joint Finance and Appropriations Committee (JFAC) will retry to submit their Medicaid budget proposal for the upcoming fiscal year 2024.
House Bill 334 (HB334) proposed a $4.7 billion budget between state and federal dollars; the House denied the proposed budget Monday through a 34-36 vote. HB334's proposal offered a 16% budget increase over fiscal year 2023.
Idaho expanded Medicaid coverage to include low-income earners behind a 2018 ballot initiative led by citizen political group Reclaim Idaho. Nearly 61% of voters approved the initiative.
JFAC committee member Rep. Colin Nash (D-Boise, Garden City) helped gather signature to get the Medicaid expansion initiative on the November 2018 ballot. He is the only Democrat on the committee.
"We have a statutory obligation to pay for Medicaid. And that's what the budget was presented as," Rep. Nash said. "We will see tomorrow how JFAC responds to what happened on the house floor."
Rep. Josh Tanner (R-Eagle) debated against the proposed budget; he also serves on JFAC. Rep. Tanner called HB334 the biggest bill the state has ever seen.
"I think we have way over jumped our numbers on this and we need to realign them," Rep. Tanner said.
Rep. Tanner told KTVB on a phone call he does not want to cut Medicaid services for anyone who needs the program; however, he believes JFAC is overestimating the true cost of Medicaid over the next year.
Medicaid is currently "unwinding." At the start of the pandemic in 2020, congress passed a relief bill that blocked states from ending Medicaid benefits for people who were no longer eligible. Idaho is now reviewing up 150,000 people who may no longer be eligible, according to the Idaho Department of Health and Welfare (IDHW).
IDHW's review will look at 30,000 people per month starting in March; the state has found 13,000 people to be ineligible so far, according to Rep. Tanner. As more people come off Medicaid in the coming months, the budget should reflect that too, Republicans argued on the House floor.
"These are healthy people. they are not using the doctor much and they have private insurance. Medicaid is the payer of last resort," Rep. Nash said. "Republicans who say we expect enormous cost savings as people come off these rolls just don't have their facts straight."
Both Rep. Nash and Rep. Tanner expect to discuss the Medicaid budget Wednesday in the regularly scheduled JFAC meeting. The item is listed on the committee's official agenda.
If the final budget underestimates the real cost, the Idaho State Legislature will have to fill the funding gap early next Legislative session in 2024.
"A lot of these things are non-discretionary. They are governed by statute," Rep. Nash said. "We're just punting. We're kicking that can further down the road until that bill is due next year. We might have to hold provider payments so hospitals - doctors - might not get paid on time until we get our act together and fund the budget like we are supposed to."
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