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House Bill 661 - Health and Welfare Department: Medicaid FY22 supplemental appropriation

House Bill 661 - Health and Welfare Department: Medicaid FY22 supplemental appropriation

by
Fred Birnbaum
February 18, 2022
Fred Birnbaum
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February 18, 2022

The Idaho Spending Index examines appropriation bills on several fronts to add important context to lawmakers’ discussions as they are considered on the floor of the House and Senate. Among the issues we look at in drawing a conclusion about a budget:

Does the agency requesting these funds serve a proper role of government? Has wasteful or duplicative spending been identified within the agency, and if so, has that spending been eliminated or corrected? Does the budget examine existing spending to look for opportunities to contain spending, e.g., through a base reduction? If there is a maintenance budget, is that maintenance budget appropriate? Are the line items appropriate in type and size, and are they absolutely necessary for serving the public? Does the budget contemplate the addition of new employees or programs? Does the appropriation increase dependency on the federal government?

Our analysis is intended to provide lawmakers and their constituents with a frame of reference for conservative budgeting, by summarizing whether appropriation measures contain items that are sincerely objectionable or sincerely supportable.

Rating -1

Bill description: To provide supplemental appropriations to cover additional costs of Medicaid expansion and other expenditures

Analysis:

This supplemental is a prime example of why Medicaid’s costs continue to increase. During the debate that preceded the implementation of Medicaid expansion, the actuarial firm, Milliman, made a number of cost saving projections for the following items: the State CAT program, the county medical indigent program, behavioral health and public health savings at the Department of Health and Welfare. Other than the wind-down of the CAT program, these other savings have evaporated. The supplemental description to JFAC, states, “no legislation supporting the implementation of a county contribution was brought forward.” 

Sadly, the notion of county and state savings from related health care programs, supposedly because of better health outcomes from Medicaid expansion has not materialized.

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