JFAC hears budget requests on Medicaid, catastrophic health care


Gov. Butch Otter receivied a firsthand look at a natural gas well last week from representatives of Alta Mesa energy company.

This week the Joint Finance-Appropriations Committee (JFAC) began listening to the Department of Health and Welfare present its budget request for fiscal year 2014. The department is requesting a total increase of 6.8 percent in spending for a total department budget of $2.52 billion.

Department of Health and Welfare Director Dick Armstrong told JFAC Monday that the department is only taking on one major program this year, which is dealing with the mandated changes to Medicaid by the federal government under the regulations being imposed under Obamacare (Affordable Care Act).

Last year, by contrast, the department pushed for legislation that would provide multiple-day dispensing of food stamp benefits, but the Legislature did not pass the measure. This year the department said it is not able to make the changes and is asking that the initiative be held.

Mandatory changes to the department in the way Medicaid is administered are expected to cost $39.3 million in upgrades involving the technological aspects of it and various reporting requirements.

The department estimates that there are 35,000 Idahoans already eligible for Medicaid under existing guidelines. Armstrong expects 22,000 more Idahoans to join due to the requirement for all individuals to have insurance or pay a fine. Armstrong told the committee that the state would pay 30 percent of the costs since those individuals fall under the current guidelines and not the expansion being discussed.

If the department does not meet the Oct. 1, 2013 deadline set by the federal government for mandatory changes, Armstrong said the state is in jeopardy of losing the 70/30 split and the federal government could reduce its share to 50 percent, thus putting the burden of an additional $380 million on the state to maintain funding at the 2014 levels.

The State Catastrophic Health Care Cost Program, a plan in which counties and the state pays for indigent care, also presented its funding request on Monday. The fund is expected to increase nearly $2 million in 2014 above the 2013 budget of $36.5 million, according to CAT program chairman Roger Christensen. However, Christensen warned committee members that the temporary Obamacare gap funding, PCIP (Pre-existing Care Insurance Program), will cause an increase of CAT applications beginning in 2015 and the committee should be prepared to address those needs in the future.

According to Christensen, the plan has more than $6 million in the bank in excess of past year expenses, roughly 17 percent in reserves. JFAC can recommend those funds remain in the bank or can return the monies back to the state general fund.

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