Latest news with #Bill345
Yahoo
02-04-2025
- Business
- Yahoo
Idaho House passes state's Medicaid budget, sending bill to governor
Members of the Idaho House of Representatives hold a floor session on March 10, 2025, at the Idaho Capitol Building in Boise. (Pat Sutphin for the Idaho Capital Sun) The Idaho Legislature this week approved an additional portion of Idaho Medicaid's budget, sending the bill to Gov. Brad Little for final consideration. Senate Bill 1201 would allocate nearly $674.2 million for Idaho Medicaid. Most of the funds — about $515.1 million — will come from the federal government, with the state's general fund contributing $70.1 million. The budget bill would fund a mix of largely administrative programs, including some that are required by the federal government or court order, along with a complex hospital tax structure. The Idaho House passed the bill on a 40-30 vote Wednesday, two days after the Senate passed the bill on a 22-13 vote. Idaho Medicaid is the state's largest government program that offers health insurance assistance to roughly 262,000 Idahoans. All told, Idaho's total Medicaid budget for next fiscal year could be almost $5.25 billion, an 11.5% growth from this fiscal year. Most of next year's budget — $3.4 billion — is set to come from the federal government, which funds most regular Medicaid costs for Idaho and 90% of Medicaid expansion's costs. The state's general fund would contribute a little less than $1 billion to Idaho Medicaid's total budget next year. The 2026 fiscal year starts in July. The bill also cuts $15.9 million in Medicaid expenses, anticipating that amount in savings from House Bill 345, a sweeping Medicaid policy reform bill Little signed that calls for work requirements, privatized Medicaid benefit management and more. SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX For the past two years, Idaho's powerful budget-setting committee has used a new practice of splitting state agencies budget bills in two categories. So-called maintenance budgets just include enough funds for essential services. New spending is included in so-called enhancement budgets, like Senate Bill 1201. Idaho's budget committee, the Joint Finance-Appropriations Committee, crafted the budget bill March 21. But 'these are not new programs' they are 'ongoing enhancements,' bill cosponsor Rep. Rod Furniss, R-Rigby, told House lawmakers in debate Wednesday. 'Many items on this budget … are expenses we've incurred. And we have an invoice for, that we need to pay,' Furniss told House lawmakers. 'These are hospital stays. These are people in homes. These are infants with brain tumors. The list goes on and on — of people that we're helping in the state of Idaho that can't help themselves.' The House's debate, which lasted over half an hour, rehashed Republican Idaho lawmakers yearslong concerns over Idaho Medicaid's growing budget. It also was another example of a newer trend this year — of state lawmakers trying to (with some success) reject state agency enhancement budgets. Calling next year's Medicaid total budget the largest Idaho has ever had, Rep. Faye Thompson, R-McCall, said she couldn't vote for a budget of this size. 'This comes at a very great cost to the working man. And it comes at a very great cost to generations that follow us, and that also includes everybody in this room,' she said. SUPPORT: YOU MAKE OUR WORK POSSIBLE
Yahoo
06-03-2025
- Health
- Yahoo
Idaho House Republicans pass bill for Medicaid work requirements, managed care
The Idaho State Capitol building in Boise on Jan. 23, 2024. (Otto Kitsinger for Idaho Capital Sun) The Idaho House — with support from every Republican House lawmaker — on Thursday widely passed a bill that proposes sweeping policy changes intended to cut Medicaid costs. House Bill 345 calls for Idaho to seek work requirements for able-bodied Idahoans on Medicaid, and to give Idahoans eligible for Medicaid expansion access to tax credits to buy insurance on Idaho's health care exchange. 'In many ways, I believe this is a broader bill that addresses the entire $5.2 billion Medicaid budget, and creates very good savings and sustainability for our state,' said Rep. Jordan Redman, R-Coeur d'Alene, who is cosponsoring the bill along with the chairs of the Idaho Legislature's health committees. The $5.2 billion figure Redman referenced appears to be the total, potential budget for Idaho Medicaid for fiscal year 2026 that Gov. Brad Little requested. But the program is mostly federally funded. Next fiscal year, Idaho would pay $1.8 billion for the program, under the governor's budget request. All nine House Democrats opposed the bill. The Idaho House debated it for less than 10 minutes Thursday. The bill's proposal for Medicaid work requirements — which requires federal approval to implement — has drawn the most opposition. But the new bill had unanimous support from House Republicans, a significant shift from another bill by Redman that would've likely repealed Medicaid expansion that narrowly passed the Idaho House last month. SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX But beyond Medicaid expansion, the bill proposes broader policy changes for the entire Medicaid program — a health care assistance program for low-income earners, people with disabilities, pregnant women, and some older people. The bill could save Idaho $15.9 million in fiscal year 2026 and even more in the future, the bill's fiscal note estimates. But the timing depends on federal approval, the fiscal note says. The bill now heads to the Idaho Senate, where it could be scheduled for a committee hearing with public testimony in the coming days before a possible vote by the full Senate. To become law, Idaho bills must pass the House and Senate, and avoid the governor's veto. Some advocates say Medicaid work requirements are costly and are effectively just administrative barriers to access the program — since almost half of Idahoans on Medicaid are already working. And many other Idahoans on Medicaid, advocates say, would be exempt from work requirements under exceptions the bill spells out, such as for parents of children age six and under, people with disabilities, college students, volunteers and caretakers. Idaho House Minority Leader Ilana Rubel, D-Boise, said the bill proposes Medicaid work requirements that 'essentially mirror' what Arkansas had. In the first seven months of Arkansas' Medicaid work requirement, one in four people subject to the rule lost coverage, the Center for Budget and Policy Priorities found. Rubel said 95% of them were working, 'but the reporting requirements were so stringent that the paperwork tripped them up. And they ended up being kicked off.' 'This is not about requiring people to work. It's about requiring people to navigate very extensive paperwork proving it,' she argued, adding that people removed from Medicaid would show up to hospitals uninsured. A majority of people enrolled in Medicaid are already working, data published by health policy research group KFF show. Some research finds Medicaid work requirements waste time and resources. About 48% of the roughly 102,000 able-bodied Idahoans on Medicaid are working, according to figures by the Idaho Department of Health and Welfare. Under the Trump administration, CMS approved work requirements in 13 states — for the first time in Medicaid's history, according to KFF. The Biden administration rescinded the approvals. Other states' experiences and a federal watchdog report suggests costs for Medicaid work requirements, alone, are high. Georgia is the only state that has Medicaid work requirements. One of 10 states that hasn't expanded Medicaid, Georgia prevailed in litigation against the Biden administration for revoking its work requirements approval. But by the end of 2024, Georgia's program 'has cost federal and state taxpayers more than $86.9 million' and enrolled just 6,500 new Medicaid participants, far under the state's goal, a recent investigation by ProPublica found. In a 2019 report studying Medicaid work requirement implementation in six states, the U.S. Government Accountability Office estimated implementing work requirements costs ranged from $6.1 million to $271.6 million. CONTACT US For the state of Arkansas, which had almost 26,000 more Medicaid expansion enrollees than Idaho currently has, implementing work requirements cost an estimated $26.1 million, the watchdog agency found. The Idaho Medicaid cost-control bill's fiscal note does not list estimates for the cost of Medicaid work requirements, or several other policy proposals in the bill. Typically, Idaho lawmakers pass separate budget bills for approved policy bills that require appropriations. The new bill would also call for Idaho to plan to shift the management of Medicaid benefits to private companies, which is called managed care and is used by most states' Medicaid programs. And the bill directs Idaho to end Idaho's use of doctor-managed care, called value care, a unique model that has existed for a few years. Rubel said Idaho's disability community strongly opposes the bill, and 'are very concerned that the forced managed care is going to undermine very important individualized services and make it difficult or impossible for them to receive those services.' Many of the bill's proposals require federal approval, and would likely take years to implement. An Idaho 'reform' bill would likely repeal voter-approved Medicaid expansion. Here's why. In 2019, Idaho failed to receive federal approval — then by the Trump administration — for Medicaid work requirements and an exchange tax credit option, which are similar to the new bill's provisions. Idaho's 2019 work requirement waiver is still listed as pending by CMS. If passed into law, the bill would take effect immediately through an emergency clause. The bill also calls for Idaho to seek federal approval to no longer allow state health officials to automatically renew Medicaid for people based on publicly available information, or to use pre-populated forms. That process is commonly called 'ex-parte renewals' in health policy jargon. But the bill doesn't include several provisions from an earlier Medicaid expansion repeal-or-reform bill by Redman that could've repealed Medicaid expansion, or removed more than half of the nearly 90,000 Idahoans enrolled in expansion. Republican lawmakers in Idaho have long worried about the federal government reducing its high match rate for Medicaid expansion. The new Medicaid cost-control bill has a provision to address if the federal government reduces its financial matching rate for Medicaid expansion, which is 90% compared to Idaho's typical federal Medicaid match rate of about 70%. If the federal financial match rate for Medicaid expansion reduces outside of a state legislative session, the bill directs the Idaho Department of Health and Welfare director to 'take any action necessary to offset the increase in state funding,' such as by cutting optional benefits or reducing provider payment rates. 'Such actions shall be taken until such time as the state legislature may convene and determine a proper course of action,' the bill says. Last week, all but one U.S. House Republicans passed a congressional budget plan — supported by President Donald Trump — that critics say would massively cut Medicaid. Trump has assured Republicans won't 'touch' Medicaid, Medicare or Social Security. U.S. House Speaker Mike Johnson pledged the focus will be on waste in Medicaid. But the Congressional Budget Office, a nonpartisan office, found that the goal to deeply cut congressional spending can't happen without cuts to benefits for Medicaid or Medicare, the Washington Post reported. Many health care policy experts also believe the tax cut goal would require deep Medicaid cuts, Roll Call reported. SUPPORT: YOU MAKE OUR WORK POSSIBLE
Yahoo
01-03-2025
- Health
- Yahoo
Idaho Legislature introduces tweaked Medicaid cost bill, with work requirements
Members of the public and Idaho officials wait for the governor to arrive to give the annual State of the State address on Jan. 6, 2025, in the House chambers of the Idaho Capitol in Boise. (Pat Sutphin for the Idaho Capital Sun) Idaho House lawmakers introduced a revised version of a bill intended to control Medicaid costs. After an unusually long debate about whether to formally introduce the bill, which would make the bill available online to the public, the Idaho House Health and Welfare Committee on a unanimous voice vote Friday introduced House Bill 345. The bill, a revised version of the 'compromise' legislation, House Bill 328, which was introduced Tuesday, proposes a range of sweeping Medicaid reforms — without the threat of repealing Medicaid expansion, a voter-passed law. The new bill is expected to have a full committee hearing next week. It calls for Idaho to seek work requirements for able-bodied Idahoans on Medicaid, and let Idahoans eligible for Medicaid expansion access tax credits to purchase insurance on Idaho's health care exchange. The new bill makes mostly minor changes to the original cost-control bill, including exempting students attending college and vocational school from work requirements, bill cosponsor Rep. Jordan Redman, R-Coeur d'Alene, told the committee. The new bill would also call for Idaho to plan to shift to management of Medicaid benefits to private companies, which is called managed care and is used by most states' Medicaid programs. And the bill directs Idaho to end Idaho's use of doctor-managed care, called value care, a unique model that has existed for a few years. Many of the bill's proposals require federal approval, and would likely take years to implement. In 2019, Idaho failed to receive federal approval — then by the Trump administration — for Medicaid work requirements and an exchange tax credit option, which are similar to the new bill's provisions. CONTACT US The bill could save Idaho $15.9 million in fiscal year 2026 and even more in the future, the bill's fiscal note estimates. But the timing depends on federal approval, the fiscal note says. The bill has not been considered by the Idaho House of Representatives or Senate. To become law, Idaho bills must pass the House and Senate, and avoid the governor's veto. If passed into law, the bill would take effect immediately through an emergency clause. But the bill doesn't include several provisions from an earlier Medicaid expansion repeal-or-reform bill by Redman. If passed, that bill would likely repeal Medicaid expansion in Idaho. But even if that bill becomes law and Idaho gets approval for all 11 policy demands, the bill could cap Medicaid expansion enrollment at less than half of current levels — and kick off people who've been enrolled in the program for three years. Senate Health and Welfare Committee Chairwoman Julie VanOrden, R-Pingree, has stopped the bill from advancing in the Senate – after it narrowly passed the House. But on Thursday, Sen. Glenneda Zuiderveld, R-Twin Falls, unsuccessfully tried to schedule the bill for a hearing in committee — citing the rising costs of Medicaid and the bill's House passage. 'This issue is too important for one person to decide for all of Idaho,' she told the Sun in a written statement via text message. 'We were all sent here to make decisions for our districts and Idaho.' Zuiderveld is a second-term legislator. Generally, Idaho Legislature committee chairs have wide discretion on deciding to grant hearings for bills assigned to their committees. That effectively gives committee chairs power to halt bills from advancing in one legislative chamber even if it passed the other chamber. But Zuiderveld told the Sun rules allow 'us to move bills out of drawers.' She did not reply to the Sun's question about whether she'd attempt the motion again. The committee's next meeting is Monday. In an interview late Thursday, VanOrden — who has served in the Idaho Legislature for nearly 10 years, including three terms in the House and is in her third term in the Senate — said she'd never seen her chair power tested in such a way. She was not at the meeting, she told the Sun, but returned minutes later to immediately adjourn the committee meeting. 'She didn't come and talk to me beforehand and say, 'This is what I'm going to do.' I think it's very disrespectful. … I think it's unethical to do something like that,' VanOrden told the Sun. Asked whether the Medicaid expansion repeal-or-reform bill is dead for the session, which is Statehouse terminology for a bill that doesn't have a chance of passing this year, VanOrden told the Sun no. 'Bills aren't dead until the session is done — for one thing. … But there are a number of us on this side of the rotunda, working with some of the legislators on the other side of the rotunda to have a replacement bill,' VanOrden told the Sun. VanOrden is co-sponsoring the new Medicaid cost control bill, along with Redman, House Health and Welfare Committee Chairman John Vander Woude, R-Nampa, and Sen. Carl Bjerke, R-Coeur d'Alene, who is vice chair of the Senate health committee. VanOrden believed the expansion repeal-or-reform bill would likely repeal Idaho Medicaid expansion. She said most of Senate leadership was worried about the repeal-or-reform bill. 'I wouldn't want to have Medicaid expansion just disappear right now,' VanOrden told the Sun. 'I think that would be very devastating for our state.' The new Medicaid cost-control bill has a provision to address if the federal government reduces its financial matching rate for Medicaid expansion, which is 90% compared to Idaho's typical federal Medicaid match rate of 70%. If the federal financial participation rate in Medicaid expansion reduces outside of a state legislative session, the bill directs the Idaho Department of Health and Welfare to 'take any action necessary to offset the increase in state funding,' such as by cutting optional benefits or reducing provider payment rates. 'Such actions shall be taken until such time as the state legislature may convene and determine a proper course of action,' the bill says. In an interview after the committee meeting, Vander Woude said the director's decisions would be subject to legislative review and are 'not absolute.' 'Part of the reason I did something like that is I was here in 2009 when we had to make budget cuts. And the director wouldn't help us at all with any suggestions,' Vander Woude told the Sun. Republican Idaho lawmakers have long worried about the federal government reducing its high match rate for Medicaid expansion. 'I suspect there's a chance that it will,' Vander Woude told the Sun. But he said he didn't know what the Idaho Health and Welfare Department director, who is currently Alex Adams, would do. The bill also calls for Idaho to seek federal approval to no longer allow state health officials to automatically renew Medicaid for people based on publicly available information, or to use pre-populated forms. That process is commonly called 'ex-parte renewals' in health policy jargon. As the House Health and Welfare Committee hearing started Friday, Vander Woude told the committee no motion was intended on the new Medicaid cost-control bill. Formally introducing the bill would delay the committee's plan for a full hearing on Monday, he said, because of time needed for legislative printing processes. But he said he wanted the public to have time to review the bill. Vander Woude noted the Idaho Legislature was three weeks from the March 21 target date to adjourn for the year, which is called sine die. 'I don't think we reach it, but … I don't want to be the one that keeps us,' Vander Woude said in committee. But after Idaho House Minority Leader Ilana Rubel, D-Boise, raised concerns about how the public would be able to access the bill if it wasn't formally introduced, the committee agreed to formally introduce it. Idaho draft bills are not posted on the Idaho Legislature's website — until committees formally vote to introduce them. After Rubel raised her concern, several lawmakers on the committee wrangled over how to make the bill publicly available without formally introducing it. The committee ultimately agreed to formally introduce the bill on a motion made by Rep. Megan Egbert, D-Boise. 'I know you guys didn't do what I asked you to,' Vander Woude told the committee as the meeting ended, and several lawmakers laughed. 'But understand, I have no angst on that at all,' Vander Woude said. 'I'm just trying to make sure that the process runs smoothly and that we get this done. And so I guess if we have to wait an extra day, we'll have to wait an extra day. I agree. I don't want the perception that we're trying to hide something and not put it out in public.' SUPPORT: YOU MAKE OUR WORK POSSIBLE
