Idaho Medicaid spending rises; analysts cite expansion launch, provider rate increases and pandemic timing

The Joint Finance-Appropriations Committee heard Thursday that Idaho’s Medicaid spending has grown sharply since the Medicaid expansion went into effect in January 2020, driven by a mix of factors including the timing of expansion, pandemic effects, provider rate increases and changes to hospital reimbursement.

“Today we're talking about the division of Medicaid,” Alex Williamson, budget and policy analyst with Legislative Services, told the committee as she opened the briefing. Williamson said the Milliman modeling used at the time of the expansion was a “best guess” and could not have anticipated the COVID-19 pandemic and subsequent utilization shifts.

The committee was shown that the expansion population — adults with incomes at or below 138% of the federal poverty guideline — began mid‑fiscal year 2020, so full-year costs first…