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JFAC approves $415.2M in FY2025 Medicaid supplementals and advances $674.2M in FY2026 Medicaid budget
Summary
The Joint Finance‑Appropriations Committee approved one‑time FY2025 supplementals to cover Medicaid costs and advanced a larger FY2026 package that funds hospital assessments, IT modernization, actuarial services and population‑forecast adjustments; both measures passed by roll call.
At a committee meeting, the Joint Finance‑Appropriations Committee approved one‑time FY2025 Medicaid supplementals totaling $415,226,800 and advanced FY2026 Medicaid enhancements totaling $674,192,600.
Alex Williamson, budget and policy analyst with Legislative Services, opened the presentation and walked the committee through a set of FY2025 supplementals and proposed FY2026 enhancements for the Division of Medicaid in the Department of Health and Welfare. The FY2025 package included a federally required managed care external quality review (EQR), implementation costs for the Idaho Behavioral Health Plan, an updated Medicaid forecast, a capitation rate increase for the Idaho Behavioral Health Plan and a hospital assessment fund deposit to draw additional federal funds under an upper payment limit methodology.
The committee approved the FY2025 supplemental package on a roll‑call vote. Senator Wintrow moved the FY2025 motion; Representative Handy seconded. The tally reported by the clerk was: Senate 7 ayes, 3 nays; House 6 ayes, 3 nays, 1 absent and excused. The motion was recorded as passing and will proceed with a “pass” recommendation.
Committee members then considered FY2026 enhancements and maintenance items that would make several of the FY2025 items ongoing and provide additional appropriations. Major items in the FY2026 package included ongoing hospital assessment funding to permit the state and hospitals to access increased federal matching dollars under a revised upper payment limit calculation; funding for the Medicaid management information system (MMIS) procurement; additional actuarial contract funds to support capitation rates and other actuarial work; required CAHPS patient‑experience surveys; a $200,000 ongoing appropriation related to the adult developmental disabilities (DD) resource‑allocation tool tied to the KW court settlement; population and FMAP forecast adjustments; and a transfer of extended employment services into the Division of Medicaid (3 full‑time positions and related funding).
Representative Furness moved the FY2026 package; Senator Burkey seconded. The committee recorded the same roll‑call tally as the earlier vote: Senate 7 ayes, 3 nays; House 6 ayes, 3 nays, 1 absent and excused. The motion will go forward as a bill with a pass recommendation.
Members and staff emphasized that many line items respond to federal requirements or recent legal obligations. Williamson said the EQR and additional CAHPS surveys are federal requirements tied to states that operate managed care. Committee members described the hospital assessment action as a way to “front” assessment funds so hospitals can access federal matching dollars that are then remitted back to hospitals to bring payments closer to Medicare rates. Senator Cook summarized the fund management approach for the MMIS project: “We put the money in a fund so that all that money has already been set aside. It's in a fund sitting there,” and explained the legislature is releasing funds to the vendor as discrete project milestones are completed.
Law‑related and contingent elements were flagged to the committee. The adult DD resource allocation funding stems from a court‑ordered settlement (referred to in the meeting as the KW lawsuit) and the fiscal effects of House Bill 345 were reflected in trailer language; committee members noted some of HB345's savings depend on obtaining federal waivers. The committee also adopted budget language requiring reports: a value‑based payment study for outpatient addiction treatment due to JFAC by Jan. 15, 2026; an update on transitioning Medicaid contract periods to fiscal‑year cycles due Jan. 15, 2026; and an annual emergency‑Medicaid report due to JFAC no later than Sept. 15 following each fiscal year.
Committee members urged attention to administration and oversight. Members noted the actuarial work supports capitation‑rate soundness and forecasting and that the actuarial contract requires more hours and funds. Several members also cautioned that reporting requirements will place workload on existing staff unless additional resources are provided.
Votes at a glance
- FY2025 one‑time Medicaid supplementals (managed care EQR; Idaho Behavioral Health Plan system configuration; updated Medicaid forecast; Behavioral Health Plan capitation rate increase; hospital assessment fund deposit, among others). Motion moved by Sen. Wintrow; seconded by Rep. Handy. Vote: Senate 7 ayes, 3 nays; House 6 ayes, 3 nays, 1 absent and excused. Outcome: passed; reported total $415,226,800 (split: $41,140,0?? — see clarifying details for full breakdown as presented to committee).
- FY2026 Medicaid enhancements and maintenance. Motion moved by Rep. Furness; seconded by Sen. Burkey. Vote: Senate 7 ayes, 3 nays; House 6 ayes, 3 nays, 1 absent and excused. Outcome: passed; reported total $674,192,600.
The committee accepted the draft budget language on the record by unanimous consent, and staff and work groups were directed to carry forward technical edits and implementation details as the bills move through the JFAC process.
