Bill description: Department of Health and Welfare, Fiscal Year 2020 Medicaid supplemental

Rating: -1 

Analysis:

This supplemental request has all of the worst features ever seen in a supplemental appropriation bill. It is unseemly in its size and adds a major policy step that very few Idahoans would likely support if they fully understood it. 

Large Medicaid supplementals are becoming the norm, in part because of higher utilization of services but also because of held payments and audit adjustments that favor providers. The Fiscal Year 2019 supplemental was $53.5 million, including $43 million from the state’s general fund. 

This Fiscal Year 2020 supplemental is $69.8 million including $18.6 million in general funds dollars. The whole process of appropriating money for Medicaid and the continued use of supplementals needs to be reviewed, but this supplemental has another bad feature.

It appropriates $16 million of federal money to set up the Idaho Health Data Exchange. Even supporters of this exchange concede its myriad startup problems. 

However, what is especially bothersome is the line item described as,  “IHDE Connections - Opioids.” 

Put simply, this project would put every citizen of Idaho’s health care records into one electronic data-base that the Medicaid Division would have access to. All of the private medical records of every Idaho citizen will be visible to certain government employees. The notion that this is necessary to “combat the opioid crisis,” is a shameful rationale for this massive invasion of privacy. 

Finally, it must be noted that having everyone’s medical records in one database will make it much easier to transition to a government-run health care system. There is no necessity for this line item to be included in the Medicaid supplemental. 

The total cost was originally $24.9 million, so the rest of the expense will be covered in the Fiscal Year 2021 appropriation.