In the 2011 legislative session, Rep. Janice McGeachin,R-IdahoFalls, successfully pushed a bill to cut $35 million out of the Medicaid budget. It appears, at least six months into the process, the state will hit its savings targets overall, though certain areas will not realize expected projections.
McGeachin’s legislation, House Bill 260, provided for $34.6 million in cuts to Medicaid.
Paul Leary, administrator in the Medicaid program, told lawmakers on the Joint Finance-Appropriations Committee Tuesday that most of the cut areas will hit targets. There are several areas in which legislators cut, including dental, psycho-social rehab and chiropractic coverage, among many others. At least 13 of the cost-savings areas will meet goals, while the other four will not. There will still be some savings in the areas not projected to meet goals.
The department is tasked with creating "enforceable co-pays" for some of its programs, a process which Leary called "fairly complex." In the run-up to last year's Medicaid cut legislation, department officials complained about the federal red tape surrounding the implementation of co-pays. Though the legislation became law on July 1, 2011, the first set of co-pays weren't instituted until Nov. 1, and the second round came Jan. 1 of this year. Because of the delays, Leary projects only 50 percent of the expected $750,000 in savings for that area.
Greater volumes of residents needing chiropractic services will likely preclude the state from meetings its $200,000 savings target in that area. Leary expects Idaho to save at least $100,000 in chiropractic services.
Cuts in pharmacy reimbursement payments, worth $2 million in savings, are on target, as is another $2 million worth of reductions in psycho-social rehab services.
The cuts are troublesome to Rep. Shirley Ringo, D-Moscow, who believes they will incur some unnecessary human suffering. "I see problems," Ringo told IdahoReporter.com. She argues that last year's legislation is forcing some recipients to choose among vital services and cutting the least important ones.
Among her complaints about the reductions, Ringo says that reduced therapy rates give no incentive for service providers to give one-on-one service to those who may need it. Therapy providers now get paid the same if they do one-on-one or group sessions. "People are hardly able to get the one-on-one time they need," Ringo explained.
The Moscow Democrat also believes that reducing some basic services will eventually lead to greater health costs in the form of more emergency room visits. "This is going to cost us some bucks," she warned. "If the consequences aren't yet felt ... they are going to be."
But Rep. Fred Wood, R-Burley, a physician, says the cuts were necessary to maintain the integrity of the overall program. “I think we have an unsustainable health delivery system at this point in time,” Wood said, adding that, “This is the first attempt to sustain the costs going forward.”
Wood quickly dismissed the notion that the cuts will harm some folks. “We aren’t going to jeopardize anyone’s future,” Wood said.