Lawmakers set Medicaid budget with planned-for cuts
Idaho budget writers approved spending for the state's Medicaid program that includes the $34.6 million in program reductions approved by the Idaho House Thursday.
The budget approved by the Joint Finance-Appropriations Committee (JFAC) actually increases state tax dollars going to Medicaid by $137 million, a 46 percent jump. That's due to a decrease in the share of Medicaid paid by the federal government, which had been boosted due to the federal stimulus program.
Medicaid offers medical services, primarily to low-income children and adults, with the federal government still contributing 65 percent of the proposed $1.8 billion in spending for the next budget year, which starts in July. The reductions approved by the House could lead to a total reduction of $108 million, given the federal match.
The four Democrats on JFAC opposed the Medicaid budget. All House Democrats also opposed the $34.6 million in reductions that passed the House.
Medicaid is part of the Idaho Department of Health and Welfare (DHW). On Friday, JFAC also approved most of DHW's budget, which includes money for state-run substance abuse treatment programs, mental health programs, food stamps, and psychiatric hospitals. Almost all of the budget followed the recommendations from Gov. Butch Otter.
Substance abuse funding would see a total $2.5 million increase, due largely to an increased federal grant for the Access to Recovery program, which offers treatment for adults who have committed misdemeanors, at-risk youth, and National Guard members who served in Iraq.
Rep. Fred Wood, R-Burley, who worked on the DHW budgets as well as the program reductions that passed the House, said there aren't other sizable changes to other DHW programs. “There is nothing fancy or strange or different about any of the other budgets,” Wood said. The state-funded welfare programs also include a $1.3 million reduction to the Aid to the Aged, Blind and Disabled program that's been approved by lawmakers.
Sen. Nicole LeFavour, D-Boise, tried to add $2.2 million to mental health spending for people dropped from state-backed treatment who could be a danger to themselves or others. That extra money would come from the Idaho Millennium Fund, which is funded by money from a national tobacco settlement. Millennium Fund dollars are paying for other parts of the DHW budget.
LeFavour said the money would prevent suicides by people who lost services, as well as violent incidents like the shooting of Ryan Mitchell of Pocatello by a man thought to be mentally ill. She offered information from DHW saying that 452 people were transferred off DHW services from mid-2008 to mid-2010. Nine of them have been incarcerated, 48 have been hospitalized at least once, and two have committed suicide.
“We would have something ensure that we have a back up so that we do prevent harm to them and harm to others,” LeFavour said.
That effort failed on a party-line vote, with the 16 Republicans on JFAC opposing it. Wood said lawmakers are planning to fund mental health services at the level requested by DHW. He also said the extra money would be an end-around circumventing the reductions approved by the House.
Wood also said the added money may not be able to stop incidents like the Pocatello shooting. “To date we haven't figured out a perfect system to prevent all of those horrible mishaps to our citizens,” he said.
Health and welfare makes up the second-largest item in Idaho's $2.5 billion state budget. Budget writers on JFAC have yet to act on the public schools budget, which would likely take up half of the general fund budget.