BOISE, ID – Budget documents from the Idaho Department of Health and Welfare show hundreds of thousands of Idahoans receive services that the governor proposed to cut.

But the records don’t paint a clear picture on how much money the state could save if it pursued those cuts — especially on whether those cuts lead to increased costs elsewhere.

“None of these proposed reductions account for any potential new costs within the Medicaid program or other state agencies resulting from reduced access to services and providers, leading to selection of alternative services,” such as emergency rooms and institutional care, “or engagement with other systems,” like the courts, prisons or jails, state health officials wrote, according to a copy of the report that the Idaho Capital Sun obtained through a public records request.

Meanwhile, Idaho state lawmakers are delving into what the governor’s proposal for $22 million in cuts to Medicaid — a public assistance program that provides health insurance to around 345,000 Idahoans — could look like.

Little proposed cutting Medicaid dental coverage, disability services

In Gov. Brad Little’s budget plan, he called for $22 million in Medicaid cuts next fiscal year — on top of extending cuts to doctor pay rates, which could save $23 million. The $22 million in extra Medicaid cuts could come from a range of rate reductions and service cuts, including potentially ending Medicaid dental coverage for adults, removing home and community-based services, or other rate reductions and service terminations, according to Little’s budget plan.

The budget documents from the Department of Health and Welfare that detail the programs on the governor’s list say:

• Dental, which covers preventive services, costs about $5.5 million in state general funds. About 231,000 adults use the service at least once a year.
• Home and community-based services, which are meant to help people with developmental disabilities live outside of institutional settings, cost about $176.5 million in state general funds. More than 16,400 Idahoans use the services at least once a year.

If home and community-based services are cut, the Department of Health and Welfare wrote that it “anticipates need for additional institutional providers as current capacity would not be sufficient to transition all Idahoans with disabilities who are served in the community today.”

The budget records, formally called a B8 form, were sent to the governor’s office on Dec. 31, Department of Health and Welfare spokesperson AJ McWhorter told the Sun.

“The Governor’s (fiscal year 2027) budget recommendation still includes the additional $22 million Medicaid spending reduction because the budget is based on the revenue forecast at the end of the fiscal year, not on month-to-month revenue changes,” she told the Sun.

Idaho lawmakers on House Health and Welfare Committee to brainstorm cuts

In the coming weeks, lawmakers in the House Health and Welfare Committee will brainstorm what those extra cuts could look like. The committee is expected to deliver its recommendations to the Legislature’s budget committee, called the Joint Finance-Appropriations Committee, or JFAC, around early February.

On Tuesday, JFAC’s new co-chair Rep. Josh Tanner spoke at length to the House Health and Welfare Committee on the process to make the cuts. He urged lawmakers to be cautious about doomsday-like warnings on the impact of cuts.

“I’ve done several cuts within Health and Welfare, a lot within public health, and it was always like, ‘This will blow up the world if I do this.’ And then I do it, and we pass it, and it goes through. And then the next year, nothing really happened,” Tanner told lawmakers.

Tanner, a Republican from Eagle, has criticized Gov. Brad Little’s budget proposal and has previously sponsored a bill to repeal Medicaid expansion, which covers about 90,000 Idahoans. Some Republicans say they’re considering repealing Medicaid expansion this year, but the governor didn’t include a plan for that in his Medicaid cut proposals.

The House Health and Welfare Committee isn’t planning to meet the rest of this week, said Rep. John Vander Woude, the committee’s chairman. He told committee members to look into the budget in the meantime.

Senate Health and Welfare Committee chairwoman is unsure of plan to tackle Medicaid cuts

The Senate Health and Welfare Committee plans to hear a presentation on Monday focused on the Department of Health and Welfare’s overall agency budget. Committee chairwoman Sen. Julie VanOrden told the Idaho Capital Sun she isn’t sure how her committee will address proposed Medicaid cuts.

“Hopefully we’ll have some discussion on what we have presented on Monday. … Maybe I’ll kind of poll members and see how they want to address that,” she said in an interview Wednesday. “Right now, at this point, we’re just trying to get through the administrative rules. And we can address budget items when we’re done with that.”

She said she’ll meet with the House committee chairman about how to then proceed.

In the House Health and Welfare Committee on Tuesday, Rep. Don Hall, a Republican from Twin Falls, asked Tanner how JFAC would factor in concerns that cuts could drive up costs elsewhere.

“Certainly it will look good if you can cut budgets on the state level, but if that just cost shifts down to the counties, (the) same citizens are paying the same taxes,” Hall said.

Tanner encouraged lawmakers to “dig in, not just listening to a lobbyist” or state health officials.

This story first appeared on Idaho Capital Sun.