JFAC hears Medicaid budget increases, implementation issues with Idaho Behavioral Health Plan

Boise — The Joint Finance-Appropriations Committee on Feb. 26 received a detailed briefing on the Division of Medicaid budget that outlined hundreds of millions of dollars in supplementals and ongoing increases and raised questions about implementation of the new Idaho Behavioral Health Plan (IBHP).

Alex Williamson, a budget and policy analyst with Legislative Services, told the committee the division’s request and the governor’s recommendations include a mix of one-time and ongoing requests tied to federal requirements, provider rate changes and system work. “This will probably feel like information overload,” Williamson said when she began the presentation.

The presentation enumerated several large items lawmakers asked about: a hospital assessment-related supplemental request of $190,000,000 for FY2025 (split on the department’s books as $77,000,000 from the hospital assessment dedicated fund and $113,000,000 federal), a capitation-rate adjustment of about $108,800,000 (one time), and a population-forecast adjustment rolling to the base of roughly $367,000,000. The department also seeks continued spending on the Medicaid Management Information System (MMIS) procurement (the state share listed as $11,700,000 and an additional federal portion of about $105,000,000), and an external quality review (EQR) supplemental around $1.3 million after recent procurements drew no bidders.

Williamson summarized program totals and use: the FY2024 appropriation for the division was about $4.56 billion, of which roughly $4.27 billion was expended; trustee and benefit payments made up over 98% of that spending. She described how participant groups drive costs differently: the basic (adults and children) population is about 51% of enrollees but accounts for about 19% of expenditures, while coordinated and enhanced…