OPINION: Navigating Idaho Medicaid

Most Republican lawmakers in the Idaho Legislature are concerned and frustrated that Medicaid costs will only continue to escalate and are unsustainable. This led to the legislature's decision earlier in the year to reject the initial Medicaid budget proposal of $4.7 billion, which many of my colleagues deemed excessive. Idaho is one of only six states that still operates Medicaid as a Fee-for-Service model.

A few weeks ago I attended a town hall meeting at the Kootenai Health Campus. It was one of a series of town halls that have taken place around the state, based on House Concurrent Resolution 9, to determine the best and most cost-effective means of implementing a third-party managed care model for Idaho Medicaid. Sen. Kevin Cook from District 32 and Rep. Jordan Redman from District 3 facilitated the discourse, and nearly all of our local legislators were in attendance.

The audience was filled primarily with physicians and other health care professionals who experience these issues every day, first hand. They spoke about their own frustrations regarding the lack of adequate reimbursement for their costs to provide care, and the challenges to adequately verify Medicaid participation. Some providers even expressed the fear that they may have to discontinue treating Medicaid patients entirely.

The town hall was lively and comprehensive, spanning topics from budget concerns to program implementation. The heart of the matter lay in finding a solution that upholds the original intent of Medicaid: providing care for children, the disabled, and the indigent in spite of the ever-growing costs of health care.

As a staunch advocate for fiscal responsibility I must stress that while health care needs to be accessible, the state budget must remain within realistic bounds. The 2024 appropriation is a staggering amount, eclipsing even our education expenditures. Furthermore, much of our Medicaid funding comes from the Federal government, which is an unpayable debt unfairly assigned to our children and grandchildren. To top it off, the message delivered to us at the town hall was that the providers themselves are subsidizing Medicaid programs further, as they are often not reimbursed at the cost of treatment.

I will voice these concerns I heard from our town hall attendees later this week when I attend a conference on Medicaid policy put on by the Council of State Governments. There I will join state lawmakers from around the country to discuss and analyze various policy solutions to Medicaid, including the process of redetermining the eligibility status of beneficiaries.

The road ahead is uncertain but we must work together to find a workable, sustainable solution. I am confident that we as Idahoans will navigate this successfully, for the benefit of all.

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Carl Bjerke is a Republican senator representing District 5 in the Idaho Legislature.