Legislative analyst outlines Health and Welfare budget growth, Medicaid drivers and agency reorganization

A Legislative Services analyst told the Idaho Senate Health and Welfare Committee that the Department of Health and Welfare's budget is projected to rise to about $6 billion in fiscal year 2026, including roughly $1.2 billion from the general fund, and described drivers of that growth along with a proposed agency reorganization.

Alex Williamson, budget and policy analyst with the Legislative Services Office, presented the department budget review during the committee meeting and walked members through recent expenditure trends, supplemental requests and major enhancements in the governor's recommendation.

"There was a bit of a spike from fiscal year '22 to '23," Williamson said, describing roughly a $670 million increase driven primarily by Medicaid adjustments and changes tied to hospital assessment and upper payment limit calculations. She told the committee that when hospitals provide the state match for an upper-payment-limit mechanism, the state's accounting records reflect larger appropriations to enable remittance of…