The state's share of the catastrophic health program could hit $40 million this year, if lawmakers approve a second appropriation for the fund.

Roger Christensen, chairman for the program, also known as the CAT fund, asked legislators on the Joint Finance-Appropriation Committee (JFAC) Tuesday for more than $17.6 million in extra money to ensure he can pay the bills through the end of the fiscal year on June 30.   Legislators appropriated $22.2 million for the CAT fund for 2012.

The CAT fund will receive some amount of its secondary request, but it's not clear how much. JFAC co-chair Dean Cameron, R-Rupert, asked to work with Christensen to justify the actual program's needs for the rest of the year. That means the supplemental request could be reduced if lawmakers don't feel the full amount is necessary.

The program continues to grow amid a still-lagging economy. In fiscal year 2007, the state paid $24.6 million for the fund. In 2011, the fund cost the state $35 million.

The 2012 supplemental funds request is not a surprise. It’s a common practice for the CAT fund to have its appropriations split in two, though one lawmaker is skeptical of that practice. "Not fully-funding the CAT fund for 2013 … I’m not sure is something I think this committee should do and I don’t think I can recommend that to the committee going forward," said Rep. Freed Wood, R-Burley.

And that's not counting the counties’ share of the program. Because counties are required to cover the first $11,000 of any case, they routinely spend millions each year on the expense. Last year, counties collectively paid more than $24 million in CAT fund claims.AdaCountyalone has budgeted $12 million for its CAT payments in 2012.

There could be relief on the horizon, at least for the CAT fund. Some indigents now covered by the CAT fund may soon be shuffled over to the Medicaid program due to new federal guidelines slated to start Jan. 1, 2014. CAT fund applicants are already screened for Medicaid eligibility, but higher income limits will mean more people on Medicaid and fewer on the state’s catastrophic program.

There won’t be a huge savings to the state, however. Idaho Department of Health and Welfare director Dick Armstrong projects the CAT fund to need about $19 million less funding each year, but also predicts that Medicaid will need that much more state money. Some CAT funds recipients will be shuffled onto the Medicaid program, thereby necessitating more funds for the federal program.