JFAC delays Medicaid funding vote pending further analysis

DMortimer_1 Sen. Dean Mortimer, right, listens to testimony in JFAC.

“I feel very uncomfortable approving funds for something for which we don’t have rules, something that has not even been vetted in our committee,” said Sen. Dean Mortimer, R-Idaho Falls. Speaking at Thursday’s Joint Finance-Appropriation Committee (JFAC) meeting, Mortimer objected to a proposed increase in state Medicaid funding for fiscal year 2013.

JFAC members were reviewing proposals for “supplemental” funding, a process whereby the budget for the current fiscal year is “re-opened” and additional funding is added to the various agencies of the government that are in need.

Committee members, for examples, unanimously approved an additional $349,400 for the Department of Agriculture to fight “pests,” and an additional $97,000 to fund unexpected seasonal firefighting needs from last spring and summer.

The committee became disagreeable, however, when reviewing Gov. Butch Otter’s request to add more than $6.3 million in additional funding for Idaho’s Medicaid program. Begun in 1965, the Medicaid program provides certain health care services to individuals and families with low incomes and limited resources. Financed with a combination of federal and state tax revenues, the expanding costs of Medicaid have in recent years become a topic of growing concern among the individual states.

Through the U.S. Department of Health and Human Services (HHS), the Obama administration is seeking to significantly alter the metric by which the states will calculate Medicaid eligibility. By attempting to impose this MAGI (Modified Adjusted Gross Income) metric, Washington is seeking not only to make Medicaid eligibility uniform across the 50 states, but also to increase the number of individuals who will be eligible for Medicaid.

In Idaho, the increase associated with the adoption of the MAGI standards is projected to be between 25,000 and 35,000 new Medicaid enrollees in 2014, according to an Idaho Department of Health and Welfare presentation to JFAC in mid-January.

“Have there been any long-term studies on the growth of Medicaid?” asked Sen. Steven Thayn, R-Emmett, in reaction to the governor’s office request for extra Medicaid funding. “If this continues to grow as it has, it will take up greater portions of our state budget and it could cut into public education funding.”

“We have drafted some long-term projections, but I have not seen them,” responded Sarah Stover, from the governor’s office of financial management.

“I suggest the governor should be examining that very carefully,” Thayn replied.

“I know there is an opinion that the MAGI rules are mandatory for the states,” Mortimer commented to the governor’s office staff members. “There is the opinion that, while some of the Medicaid mandates of Obamacare were overturned by the Supreme Court’s ruling on the law, the MAGI rules were not overturned, and that is the assumption that the governor’s office is operating with. My read of the Supreme Court ruling, however, tells me that imposing the MAGI rules are not necessary for Idaho.”

Mortimer recommended that the committee defer any further action, until further analysis is completed.  The committee then voted to delay action on the extra Medicaid funding, until its Feb. 7 meeting.

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