Idaho House passes $4B budget for Medicaid

BOISE — The first $4 billion agency budget in state history was one of several appropriations bills approved by the Idaho Legislature on Tuesday.

The fiscal 2023 budget for the Department of Health and Welfare’s Medicaid Division passed the House on a 43-27 vote, following a brief debate.

The $4.04 billion budget is up $249.3 million or 6.6% over the current year. That includes a $167.2 million increase in federal funding for provider rate increases, as well as service improvements related to a lawsuit settlement.

State funding for Medicaid next year amounts to $830 million, or about 20% of the overall budget. That’s an increase of $60.3 million or 7.8% compared to 2022.

Reps. Priscilla Giddings, R-White Bird, and Charlie Shepherd, R-Pollock, opposed the bill. All other representatives from north central Idaho voted for the bill.

Rep. Ron Nate, R-Rexburg, noted that the Medicaid budget has more than doubled since he first came to the Legislature in 2015.

“Where’s the outrage?” he asked. “Where’s the concern over out-of-control growth? This spending is clearly unsustainable.”

Rep. Paul Amador, R-Coeur d’Alene, agreed. However, he noted that the proper way to address such concerns is to change state policy. The appropriation bill itself, he said, simply pays the bills for policies the Legislature itself enacted.

“If you’re concerned about Medicaid spending, as I am, then I’d certainly welcome your work on the underlying policy,” he said.

The budget now goes to the Senate for further action.

Other legislation that passed the House and/or Senate on Tuesday includes:

Agricultural research — The fiscal 2023 budget for the Agricultural Research and Extension Service passed the Senate unanimously and headed to the House for further action.

The $35.8 million spending plan includes $35.4 million in state general fund support. That’s a $2.7 million, 8.3% increase over the current year.

Most of the added funding is for employee wage increases. The budget also includes $360,000 for a new 4-H educator, operating manager and research scientist at the Center for Agriculture, Food and Environment facility in the Magic Valley.

Medical residencies and health education — The Senate approved a $25.2 million budget for health education programs.

That’s an increase of $1.68 million or 7.2% over the current year, with almost all of that going to expand the number of medical residency positions in Idaho.

After they complete their classroom training, medical students must complete a residency program before they’re licensed to practice medicine on their own.

Research also shows that doctors are highly likely to practice medicine within 100 miles of the location where they completed their residency. Consequently, the Legislature has been investing in new residency positions as a means of increasing the number of doctors in the state.

The 2023 health education budget includes funding for 21 new residency slots — up from the 14 included in the governor’s budget recommendation.

The bill now goes to the House for further action.

Kindergarten funding — The Senate Education Committee took less than five minutes to recommend approval of House Bill 790, which is the latest version of a kindergarten/literacy funding bill.

The measure lets school districts us state literacy intervention funds for a variety of purposes, including optional all-day kindergarten classes.

The bill passed the House on a 40-29 vote Monday. It now goes to the full Senate for further action.

County lease financing — The Senate approved House Bill 575, which restricts a county’s ability to enter into long-term lease agreements for jail or courthouse facilities unless they secure a public vote.

Sen. Robert Blair, R-Kendrick, was the only person to debate against the bill. He said it takes away local control and hinders a county’s ability to finance projects.

Moreover, since the state Department of Administration also uses long-term leases, he suggested it was hypocritical for the Legislature to take that option away from counties.

“Why is this Legislature restricting local government?” he asked.

The bill previously passed the House on a 53-15 vote and now goes to the governor for his consideration.

Property tax relief — The Senate unanimously approved House Bill 481, which helps more elderly, low-income Idahoans qualify for the circuit breaker property tax relief program.

The bill, which was sponsored by Rep. Charlie Shepherd, R-Pollock, increases the home value cap to qualify for the program from 125% of the county median assessed value to 150% or $300,000, whichever is greater.

Increasing the cap will help hundreds of Idahoans who otherwise would have been kicked off the program to qualify for up to $1,500 per year in property tax relief.

The measure now goes to the governor for his signature.

In other action Tuesday, Gov. Brad Little and State Controller Brandon Woolf announced a new government transparency website, Townhall.Idaho.gov, which provides a one-stop location for public meeting information for executive branch agencies.

Little signed an executive order directing state agencies to post meeting notices, agendas and minutes on the website beginning April 15. That’s in addition to any existing statutory requirements for posting meeting notices.

Woolf said the website will eventually be expanded to include local governments throughout the state, so people won’t have to search through multiple agency or government websites to find out what’s going on.

During a brief news conference, Little said increasing confidence in state government has been a key priority since his first day in office.

“In 2020, we set up a dedicated complaint line for state employees to report fraud, waste and abuse,” he said. “Then, throughout the pandemic, Controller Woolf and my administration worked closely together to report all expenditures for (federal) relief funds on the Transparent Idaho website (transparent.idaho.gov).”

Tuesday’s news conference was scheduled last Friday, a day after the Society of Professional Journalists gave Lt. Gov. Janice McGeachin its annual “Black Hole Award” for her refusal to release public comments regarding her 2021 indoctrination task force.

McGeachin is challenging Little for this year’s Republican gubernatorial nomination.

Spence may be contacted at bspence@lmtribune.com or (208) 791-9168.