Idaho Republicans: Counties, Savings Should Pay For Medicaid Expansion

Sep 15, 2019

Counties could end up paying for a significant part of Idaho’s voter-approved Medicaid expansion after it’s rolled out next year.

A legislative committee is almost done drafting its recommendation to lawmakers on how to pay for the state’s estimated $41 million share of the expansion in fiscal year 2021.

Republicans want almost a quarter of that bill, up to $10 million, to be covered by counties, noting that they shouldn't have to pay as much for indigent healthcare. But Democrats, like Sen. Marianne Jordan (D-Boise), say voters who helped pass Medicaid expansion, wanted the state to pay for those costs.

“Never did they vote on their property taxes going to pay for Medicaid expansion,” Jordan said.

She, and the Rep. Brooke Green (D-Boise), the other Democrat on the committee, voted against the proposal, saying it could also force counties to raise property taxes to cover a potential budget shortfall.  

But Sen. Jim Rice (R-Caldwell), who co-chairs the committee, repeated what many Republicans have been saying since last year’s election: no one ever sketched out how the expansion would be paid for. 

“Taking a look at this does not violate some magical initiative language that wasn’t there,” Rice said.

The committee recommends the rest of the program, which is about $20 million, be paid for through savings to state agencies and by cutting the catastrophic healthcare budget.

Additional cash from Idaho’s tobacco settlement fund could’ve covered the bills counties may have to pay for, but lawmakers declined to do so. That settlement fund is already slated to help pay for the first six months of the expansion beginning Jan. 1.

They will vote on the final plan in November.

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