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Citing concerns over growing costs, Idaho Senate passes Medicaid budget by one vote

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Citing concerns over growing costs, Idaho Senate passes Medicaid budget by one vote

Mar 30, 2023 | 7:37 pm ET
By Clark Corbin
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Citing concerns over growing costs, Idaho Senate passes Medicaid budget by one vote
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The Idaho Senate in session at the Idaho Capitol in Boise on April 6, 2021. (Otto Kitsinger for Idaho Capital Sun)

The Idaho Senate passed the fiscal year 2024 Medicaid budget by a single vote Thursday, removing one of the major obstacles in the way of wrapping up the 2023 legislative session. 

Ten days ago, the Idaho House of Representatives killed the original Medicaid budget after several Republicans complained about the budget’s overall bottom line — $4.7 billion in total spending from all funding sources.

That forced the Joint Finance-Appropriations Committee to rewrite the Medicaid budget and cut it by about $150 million in anticipation of Idaho Department of Health and Welfare officials removing people who are ineligible to participate in the Medicaid program.

The fiscal year 2024 Medicaid budget includes funding for five programs, including expanded Medicaid coverage for Idahoans earning less than 138% of the federal poverty limit. In 2018, 60.6% of Idaho voters approved a ballot initiative to expand Medicaid coverage to low-income Idahoans. 

About 66% of the money in the Medicaid budget comes from federal funding. 

Senators who supported the budget said the state is obligated to pay the valid claims in the Medicaid budget. Low-balling or cutting the budget now would cause the Idaho Legislature to pass a supplemental budget next year to cover the claims.

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“We are going to pay these bills one way or the other,” Senate President Pro Tem Chuck Winder, R-Boise, said on the Senate floor. “You can face it as a supplement when you come back next year. But the reality of that is we’re obligated as members of this Legislature to leave here with a balanced budget. And you can vote against every budget you want, but we are constitutionally obligated to have a budget before we leave here.” 

Some legislators said that didn’t matter, and that spending for the program has gotten too high. 

“We continue to have higher and higher costs and it seems like the more government gets involved in this, the more expensive it becomes,” Sen. Tammy Nichols, R-Middleton, said. 

In the end, the Idaho Senate voted 18-17 to pass the budget. 

The 2024 Medicaid budget next heads to Gov. Brad Little. The Idaho House of Representatives voted 40-30 to pass the Medicaid budget on Wednesday

Idaho legislators working to wrap up 2023 legislative session

Thursday marked the 81st day of the 2023 legislative session. Although the Medicaid budget was among the last bills legislators were considering before potentially wrapping up their business for the year, the Idaho Senate still had more than 30 pending gubernatorial appointments on its calendar as of late Thursday afternoon.

If legislators close out the session similar to how they did last year, they could wrap up their business late Thursday or on Friday and go at recess for a few days to see if Little vetoes any late-session bills or budgets. Under that scenario, legislators would return to the Idaho State Capitol in Boise late next week, consider overriding any potential vetoes and then adjourn the session for the year “sine die.”