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.

Betsy Z. Russell is the Boise bureau chief and state capitol reporter for the Idaho Press and Adams Publishing Group. Follow her on Twitter at @BetsyZRussell.

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