BOISE, ID – The Idaho Legislature’s budget committee voted to set the Medicaid budget without acting on the governor’s call for $22 million in cuts on Friday.

The Joint Finance-Appropriations Committee, or JFAC, ultimately approved a range of Medicaid budget enhancements for roughly $493 million. The moves would set the program’s budget at $5.54 billion next fiscal year, a few million dollars over what Gov. Brad Little recommended.

JFAC voted to approve a motion by Rep. Chris Bruce, R-Kuna, that doesn’t plan for Medicaid cuts. That came after the committee rejected two proposals that would’ve planned for cuts.

JFAC co-chair Rep. Josh Tanner, R-Eagle, critiqued the cut proposals as short-sighted by reducing the state’s estimate for Medicaid costs that the state will be on the hook to pay.

“To think that also now we’re going to have a cost decrease is kind of, in my opinion, throwing every logic out the window,” Tanner said.

Months into Idaho legislative session, Medicaid cuts are stalling

Nearly two months into the legislative session, the Idaho Legislature has not significantly advanced bills to cut Medicaid services. That’s despite the governor’s budget plan calling for $22 million in Medicaid cuts, including to disability services. Before the legislative session, some Republicans signaled they were open to repealing Medicaid expansion.

A bill responding to Little’s call for Medicaid cuts stalled in the House Health and Welfare Committee on Thursday. The committee shelved the bill — which would cut $21.8 million from Medicaid provider payment rates for a disability service called residential habilitation — for nearly a week to improve language.

JFAC’s actions Friday tees the Medicaid enhancement budget items to be drafted into a bill for consideration by the House and Senate.

In an interview Friday, Bruce called the other approaches that would’ve planned for Medicaid cuts “wishful thinking.”

“I just want to be more transparent with the people about what we’re spending,” he told the Idaho Capital Sun.

What the other two motions would’ve done

One motion, by Sen. Kevin Cook, R-Idaho Falls, would’ve split Little’s recommendation for $22 million in cuts across residential habilitation, a disability service that some lawmakers are eyeing for cuts, and Medicaid claims payments more broadly. That second cut area would essentially mean the state would hedge its estimate for program costs next year, which can vary and leave the state on the hook to pay more later on.

“I truly believe … we need to look under the couch cushions and find some change, and anywhere we can to find money,” Cook told JFAC.

He worried that aiming all the $22 million in cuts toward residential rehabilitation would risk shuttering businesses that provide the services, and leave the state paying more for care. He argued that would effectively amount to a 10% cut to the service’s rates, since the Department of Health and Welfare already cut Medicaid provider pay rates by 4%.

A separate proposal by Sen. Melissa Wintrow, a Boise Democrat, would not have made any service cuts. It would have just cut the state’s Medicaid service claims estimate by $22 million, which appeared on the motion as “governor initiatives.” Wintrow said that amounts to about four and a half days of Medicaid receipts. She said the Department of Health and Welfare’s 4% provider rate cuts already “wreaked havoc on a lot of services,” pointing to three deaths of patients on a severe mental illness program that got cut three months ago.

“This motion is about harm reduction,” Wintrow told JFAC. “We have already cut the hair so much beyond the buzzcut. We’re doing scalp removal here.”

The motion failed after getting support from only Wintrow and Boise Democratic Sen. Janie Ward-Engelking. Rep. Brooke Green, the sole House Democrat on JFAC, was absent.

Idaho Capital Sun is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Idaho Capital Sun maintains editorial independence. Contact Editor Christina Lords for questions: info@idahocapitalsun.com.