Rising Costs
For FY24, the Department is requesting $67 million for Medicaid Expansion, which is an increased ask compared to last year's budget request.
A significant part of the questions from Legislators focused on the rising cost of expansion, which Ms. Charron explained was due to several contributing factors, including rapid state growth and utilization of services, continued inflation, and a pandemic.
Medicaid Expansion began taking effect in January 2020. During the program's infancy, the Families First Coronavirus Response Act required all Medicaid programs to maintain enrollment throughout the public health emergency. This federal requirement has resulted in approximately 67,000 ineligible Medicaid Expansion participants in Idaho. The redetermination of eligibility effort by the Department, which will take place over the next six months, may result in a decrease in program participants. However, the figures are mere estimates currently.
Despite the rise in costs, the Department informed Legislators that if the State were to remove itself from Medicaid Expansion, the Department estimates that it would actually cost the state more - approximately $77 million. This has to do with a number of factors, including the state's increasing spending on behavioral health crisis centers and the current 90-10 payment split with the federal government.
Cost Containment
Realizing that costs were increasing, the Department of Health and Welfare proactively took action to contain them. The Department explained how it had been focused on preventative care by connecting new enrollees with a primary care physician and engaging with a third-party consultant. Through the Division of Financial Management, a third-party consultant was hired to review the program with the end goal of finding additional cost containment strategies. An interim report has been released to the Department, and those findings are currently under review. A full report is scheduled to be released sometime in April of this year and could contain recommendations for provider reimbursement cuts.
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