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Senate Bill 1185 — Medicaid Appropriation

Senate Bill 1185 — Medicaid Appropriation

Fred Birnbaum
March 15, 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 appropriation

Rating: -1

This is the single biggest budget bill in Idaho’s history, a $3.733 billion budget buster, 19.8% greater than the FY21 appropriation. Where to begin. This budget is bigger than the entire budget of Idaho for everything in FY01. This budget appropriation is on top of the $369.8 million FY21 Medicaid supplemental, House Bill 216 which was signed into law on 3/11/21.

Several points to note: 1. There is no strategic plan or policy to get this spending under control. Just a vague notion that a value-based payment strategy will help. 2. The Governor’s cost containment line item to reduce expenditures by $30 million in general fund dollars was rejected by JFAC. 3. Medicaid expansion cost savings “sideboards,” that accompanied S1204 have been openly abandoned. This program is on auto-pilot and climbing like a rocket ship headed to the moon. 

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