After hours of discussion, a divided legislative panel charged with finding “equitable” ways to fund Medicaid expansion in Idaho has voted along party lines to ask Idaho counties to kick in up to $10 million next year. The idea is that counties won’t need to spend as much on county medical indigency expenses — which now come straight out of local property taxes — once Medicaid is expanded. Opponents suggested local property tax relief would be a better use for those savings, and argued that Idaho doesn’t yet know how the expansion will impact county finances a year from now.
“The committee’s recommendations would shift the state’s responsibility for the Medicaid match onto property taxpayers,” said Sen. Maryanne Jordan, D-Boise. She proposed an unsuccessful motion to wait a year to see how county costs change, and then consider the issue.
Majority Republicans on the House-Senate panel backed proposals from Co-Chairman Sen. Jim Rice, R-Caldwell, to ask the counties for up to $10 million in fiscal year 2021, which begins July 1, 2020, with several caveats. The counties might not have to contribute until their fiscal year starts Oct. 1. They’d make their contribution by giving up a percentage of their state sales tax revenue-sharing distribution, rather than directly from property taxes, but only if the existing charitable and justice levies now charged to county property taxpayers are combined. And if any county experienced a spike in medical indigency costs in fiscal year 2021, it wouldn’t have to pay a full share, with the state instead filling the gap from its tobacco settlement Millennium Fund.
Rice’s complex proposals drew lots of questions, but only the panel’s two minority Democrats voted against them. Several said the amount was lower than the $20 million they’d anticipated seeking from counties next year.
Idaho voters approved Medicaid expansion last November; it takes effect Jan. 1. For the first six months, it already has been funded at no cost to the state general fund, drawing roughly $10.8 million from the Millennium Fund and the rest from savings the state will realize in programs from Corrections to Health & Welfare thanks to the expansion. The federal government pays for 90% of the costs of expanded Medicaid, which covers people who make between 100 and 138% of the federal poverty level; the legislative panel was just looking at funding sources for the state’s 10% share moving forward after next July 1, which is estimated at around $41.9 million for the full budget year. You can read my full story here at idahopress.com (subscription required), or pick up the Idaho Press.