© 2024 Boise State Public Radio
NPR in Idaho
Play Live Radio
Next Up:
0:00
0:00
0:00 0:00
Available On Air Stations
Chad Daybell's murder trial has begun. Follow along here.
In the world of social programs, Medicaid is one of the hardest to understand. It’s something of a catch-all program for low-income people, covering broad and divergent needs. Included are healthy children and adults with eligible dependent children, people with disabilities or special health needs, and the elderly. Eligibility is income-based and it varies according the category of qualification for the program.During the state’s 2011 fiscal year, more than three quarters of the funding allocated to the Department of Health and Welfare’s budget went to Medicaid. The program received about $1.55 billion in federal and state funding, with 74 percent of those dollars coming from the federal government.Enrollment in Idaho’s Medicaid program has grown substantially in recent years. The average monthly Medicaid enrollment was fairly stable between 2006 and 2008. It grew by about 3.5 percent. But in the last three years, the program’s enrollment has grown nearly 21 percent. Ballooning from about 185,000 in 2008 to 228,897 in 2012.

Supreme Court Sides With Idaho Over Medicaid Rates, Providers Fear Patients Will Be Hurt

Wally Gobetz
/
Flickr Creative Commons

The U.S. Supreme Court ruled 5-4 Tuesday in favor of the State of Idaho in a fight over Medicaid payments to providers. The decision could impact Medicaid's low-income patients across the state. 

The case began after a 2009 lawsuit against the state. Officials with Idaho's Department of Health and Welfare had recommended increasing payment rates to private medical providers who serve Medicaid patients.

But the Idaho Legislature didn't act on the recommendations and the rates stayed the same.

Tuesday's decision reverses a lower court's ruling, asserting that private medical companies don't have a right to enforce federal Medicaid rules. Justices in the majority said it's up to federal agencies to decide whether a state is following the law.

Boise Attorney James Piotrowski argued on behalf of healthcare providers. Piotrowski says his client named in the suit – a rehab center for developmentally delayed patients – was already being underpaid.

"It will be harder and harder for healthcare providers to justify participating in the Medicaid program," he says. "The rates were low to begin with and they're likely to get lower."

He says Idaho is violating the federal Medicaid Act by not paying providers a rate consistent with rising costs and inflation, putting healthcare providers in a tough spot.

"We already have a problem in Idaho because our state is so rural with being able to access services. This is going to make that problem even worse."

Piotrowski says the decision could force some healthcare centers to close.

Attorney General Lawrence Wasden, meanwhile, hailed the decision. He's argued the authority to set Medicaid reimbursement rates should rest with the state Legislature.

Find Frankie Barnhill on Twitter @FABarnhill

Copyright 2015 Boise State Public Radio

Frankie Barnhill was the Senior Producer of Idaho Matters, Boise State Public Radio's daily show and podcast.

You make stories like this possible.

The biggest portion of Boise State Public Radio's funding comes from readers like you who value fact-based journalism and trustworthy information.

Your donation today helps make our local reporting free for our entire community.