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House Bill 382 — Medicaid Additional Appropriation

House Bill 382 — Medicaid Additional Appropriation

Fred Birnbaum
April 27, 2021

The Idaho Spending Index examines appropriation bills on several fronts to add some important context to lawmakers’ discussions as the spending bills are considered on the House and Senate floors. As we look at the budget, we consider the following issues:

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? Have budget-writers reviewed existing outlays 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 adding 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 truly  objectionable or legitimate and worthy of support.

Bill Description: Health and Welfare department, Division of Medicaid, FY22 additional appropriation

Rating: -1

This is the third major Medicaid appropriation (of this session) bill since the original FY21 appropriation for Medicaid, last session. H216 was a FY21 supplemental which added $370 million to Medicaid. S1185 is the FY22 Medicaid appropriation for $3.733 billion and a $618 million increase over FY21. S1185 contains no cost containment, either.

Now the legislature is presented with this bill, a FY21 and FY22 top off for Medicaid, another $78 million appropriation. This appropriation is funded by the American Rescue Plan Act (ARPA). What is interesting about this is that every Republican member of Congress (who voted), voted no. Now Idaho is posed to accept this money as if there is no alternative. The additional funds are to be used for temporary pay increases or bonuses for direct care workers, although the Division could not identify how many people would qualify for the money. Again, this another case of using borrowed funds to throw temporary money at people. 

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