On Wednesday, House members voted 52-14 to approve what one lawmaker called a “structurally balanced” Medicaid budget. The 2013 Medicaid spending plan will add $103 million in total funds over last year, with $38 million of that coming from the state general fund.

Overall, the proposed Medicaid budget is more than $1.9 billion, though $474 million of that are state funds.
Medicaid is a joint federal and state program aiding low-income individuals or families in paying for the costs associated with long-term medical and custodial care, provided they qualify. It is primarily funded by the federal government, but the program is managed by the state.

The new state money in the 2013 budget comes after a self-imposed tax on hospitals and other medical service centers included in the 2012 spending plan expires. The new money represents an 8.9 percent hike in state spending for the program.

The bill’s sponsor, Rep. Fred Wood, R-Burley, said removal of the tax brings the budget into “structural balance” after several years of unsteadiness.

Lawmakers set forth $474 million in state spending on Medicaid for 2013.

This is the second year in a row a similar scenario has played out in budget committee. In the 2012 budget, federal support included in the 2009 stimulus package for the Medicaid program, traditionally split 70/30 with Idaho, dropped slightly, causing the state to add more money for the expense. The budget added $137 million in state money for Medicaid

Included in the spending plan is $300,000 in state funds to ready Idaho’s Medicaid system to integrate with an online health exchange. The money will aid the state in developing a real-time welfare qualification system that will be available 24 hours per day. The state money leverages federal funding with a 90/10 match, meaning the feds are pitching in $3 million for the project.

But that’s just in one division of Medicaid. In a separate division, the state is allocating $820,000 for the project, leveraging another $7.38 million in federal funding.

Another reason for the increase is a reversal of some of last year’s Medicaid cuts. Earlier this week, the Idaho House passed a bill to provide dental services for aged and disabled program recipients along with restoring some programs for those with dual diagnoses. The bill will cost $1.5 million next year and passed the House 65-0.

House Minority Leader John Rusche, D-Lewiston, supported the budget, though somewhat reluctantly. Rusche praised the money to reverse some of the Medicaid cuts, as well as the inclusion of the funds to integrate the program with an online exchange. Still, he thought the state could have reversed more of the cuts.

“I certainly believe we could have done more,” Rusche said. He was a vocal critical of a $35 million tax cuts passed by the House earlier this year, saying that before giving out tax breaks, the state should fill state funding gaps.
The new state money will also bring the state spending on Medicaid to its highest rate in the last few years. Of

Idaho’s $2.7 billion 2013 budget, Medicaid’s $474 million in state money represents 17.55 percent of overall expenses.
That’s up from 2012, when the $436 million Medicaid budget represented 17.09 percent of state spending. It’s a sharp spike from 2007 when lawmakers put $340 million into Medicaid, or 13.9 percent of the Idaho’s spending that year.

The low percentage point of the last few years came in 2009, when the state spent $327.5 million on Medicaid, amounting to 12 percent of that year’s spending.