Health and Welfare members urge JFAC to review Medicaid pharmacy spending, program transfers and consider shifting LIHEAP

Members of the House Health and Welfare Committee offered guidance to the Joint Finance‑Appropriations Committee (JFAC) on several budget priorities and potential shifts, urging a closer review of Medicaid pharmacy spending, reconsideration of program placements and small changes to transfer rules and staffing.

Representative Kaler reported that she and Representative Redmond completed a Medicaid budget review and said the committee should examine pharmacy spending: “There was over 500,000,000 spent in fiscal year 2022,” she said, and asked for data on which drugs and patient groups are driving those costs. Kaler and others also recommended shifting programs such as LIHEAP (Low Income Home Energy Assistance Program) and the Weatherization Assistance Program from the Department of Health and Welfare to the energy portfolio to concentrate public‑health resources on disease surveillance and vital statistics.

Representative Bieswanger and others discussed foster care staffing and long‑term cost drivers. Bieswanger said earlier intervention and more staff could reduce the use of costly group placements: he contrasted the expense of group homes “which are hundreds of dollars per day” with lower‑cost alternatives (he cited a figure of about $16 per day for other options) and supported adding staff earlier in the service continuum to lower total system costs.

On substance abuse and prevention, Representative Wheeler and Representative Thompson said the division manages funds efficiently and asked JFAC to favor block grants for flexibility. Wheeler urged consideration of education funding tied to prevention work, including potential use of Millennium Fund dollars for vaping education.

Representative Egbert raised a technical budget issue in behavioral health: he said the department currently adheres to transfer limitations more stringent than Idaho code and asked that JFAC consider exempting the department’s internal 10% transfer limit so funds could be shifted between program areas (for example, from children’s mental health to adult mental health) as needed.

Representative Egbert also provided an agency estimate of overall mental health funding: “the agency request for the year for total for, mental health, I believe is about 51, million,” he said, and noted most of the funds flow through the Magellan contract for behavioral‑health services, with some state costs remaining for involuntary holds and designated exams.

Representative Levitt raised concerns about the role of advocacy organizations participating in budget testimony, saying that some groups should not use staff time to engage in what he termed activism while seeking taxpayer funding. Levitt also relayed figures for LIHEAP and winterization mentioned in the meetings and encouraged moving those programs to a more energy‑focused agency.

Chair and committee members said they had recorded members’ suggestions and would present the notes to JFAC. No formal budget transfers or appropriations were adopted at the meeting; members requested fiscal notes and agency responses ahead of JFAC deliberations.