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Senate Bill 1081 — Catastrophic Health Care Supplemental

Senate Bill 1081 — Catastrophic Health Care Supplemental

Fred Birnbaum
February 10, 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: Catastrophic Health Care Supplemental Appropriation

Rating: -1

The CAT program was established to meet the needs of the medically indigent residents of Idaho who don’t qualify for other programs. This legislation would add $6 million in General Funds to the CAT program for FY21.

One of the key selling points of Medicaid expansion during the 2018 public debate was that Medicaid expansion would reduce the costs of the CAT program. The 2018 Milliman Report projected cost savings, and the state accepted their projections. The report forecasted that costs would fall 50% by FY22. There is no evidence that this goal will be achieved.

What is particularly troubling about this $6 million supplemental is that it comes on top of a FY21 appropriation of only $3.5 million, which clearly was not enough to meet the caseload costs, given the FY18-20 cost history. The FY21 original appropriation was a clear example of poor budgeting, and this supplemental request is simply a reflection of that.

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