Bill description: HB 563 would establish the Plan First Idaho program, under the Department of Health and Welfare, to provide family planning services and supplies.
Does it create, expand, or enlarge any agency, board, program, function, or activity of government? Conversely, does it eliminate or curtail the size or scope of government?
HB 563 would increase the scope of Idaho’s Medicaid program to include providing family planning services and supplies to women between the ages of 19 and 44, who are at or below 133 percent of the Federal Poverty Level. These supplies and services could include contraceptives but would not include abortions. The figures used in the Fiscal Note for HB 563 are based on an estimate of 38,000 women being eligible for the program with 14,060 participating.
Does it increase government spending (for objectionable purposes) or debt? Conversely, does it decrease government spending or debt?
According to the Fiscal Note for HB 563, expanding the scope of Idaho’s Medicaid program would cost $28.82 million over a five year period. Of this sum, $25.67 million would be federal tax dollars, and $3.15 million would come from Idaho’s general fund.
The Fiscal Note estimates that offering these family planning services would have a two-to-one return on investment over the five year period. The Note asserts there would be lower costs for prenatal care, labor and delivery, postpartum care, and the cost of care for an infant’s first year of life.
Increased spending on healthcare programs is often accompanied by cost-saving claims. Yet, as concerns Medicaid, its budget is one of the largest and fastest growing in the total Idaho budget. From FY17 to FY19 request, which does not include the program added under this legislation, spending is up 19.8%, while the caseload is up only 4.1%—which is an unsustainable increase in spending.
There are no real base-points or suitable metrics to measure the overall validity of these cost-saving claims. There are many studies, but the end result is that entitlement costs climb much faster than general inflation.
The Plan First Idaho program is not in the budget for Medicaid and is the third such add-on program to Medicaid. The other two add-on programs are the dual-waiver and the addition of preventative dental services to Medicaid. Only the dual-waiver was a budgeted request.
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