Bill Description: Senate Bill 1283 grants supplemental Medicaid funding to ambulance services.
Does it violate the principles of federalism by increasing federal authority, yielding to federal blandishments, or incorporating changeable federal laws into Idaho statutes or rules?
SB 1283 makes state emergency services highly dependent on the federal government for rendering care to Medicaid participants. In fact, the $20 million figure for annual federal expenditures is only an estimation. This legislation does not outline how much spending this program should authorize, nor does it detail how the funds will be allocated to ambulance service providers.
Section 6 of this bill yields the entire mechanism for qualifying, appropriating, and distributing these additional Medicaid dollars to the federal government. This allows for strings to be attached to this funding that can overrule state-level policy.
For instance, the U.S. Supreme Court used a Jan. 13 ruling to halt a proposed mandate on large employers, it let stand a federal vaccine mandate on employers that receive Medicare and Medicaid dollars. It is probable that a vaccine mandate on local emergency services personnel would be a contingency for the receipt of these additional Medicaid dollars.
Overall, SB 1283 expands the reach of federal policy at the state level, superseding Idaho statutes and rules.
Currently, Medicaid payment for services is final. This means that providers are not able to bill participants personally for unfunded expenses, unless the participant was notified of this before care was provided. This is not a luxury afforded to the emergent nature of the work of an ambulance service. Therefore, unfunded expenses are absorbed by the provider, passing costs along to the constituents through local taxes.
SB 1283 supplements the unfunded costs to ambulance services with an estimated $20 million in federal funding, annually. This retains the burden on taxpayers through printed, borrowed, and taxed money. Despite the fact that this bill does not directly increase government spending, it can generate more debt through changing who pays for Medicaid participants’ ambulance services.
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