On health care, Gov. Brad Little is proposing funding Medicaid expansion with zero impact on the state general fund next year, but his proposal includes tapping Idaho counties for $8.5 million of the $40 million cost. The governor’s budget director characterized that as a “starting point for those discussions.” Policy legislation would have to be hashed out with lawmakers. Little’s budget funds the remainder of the costs of the state’s 10% share of Medicaid expansion – the federal government will cover 90% of the costs – with $9.3 million already in the base from savings offsets to the Health & Welfare and Corrections budgets; $12.5 million from the Millennium Fund, an endowment set up from tobacco settlement funds; and $10.6 million in additional general-fund offsets expected in the coming year from savings in state budgets due to the expansion of Medicaid.
“My budget implements a full year of Medicaid Expansion with a net-zero impact on the General Fund,” Little told lawmakers.
The governor’s budget also includes ongoing funding for 25 new medical residencies, aimed at alleviating Idaho’s physician shortage; spending more than $30 million in one-time dedicated and federal funds to fight opioid abuse; providing $500,000 in one-time general funds for community-based recovery centers; developing a state advanced care directive registry; and continuing to fund the Department of Health & Welfare’s child welfare transformation, at $5.3 million for its final year next year, including adding five social worker positions. Home visitation programs also would get a boost, at $1 million, aimed at preventing child abuse and neglect and promoting school readiness.