Idaho’s Rising Medicaid Enrollment Drives Costs
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Bruce Vladeck, who directed the federal Medicare and Medicaid programs for four years in the 1990s, summed up the Medicaid program this way. “Medicaid isn’t rocket science,” he said. “It’s harder and more expensive.” Years later, a poster echoing those words hangs in Idaho Medicaid Administrator Paul Leary’s office.
It’s true that 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, which is income-based, varies according to the category of qualification for the program.
As for the “expensive” part of Vladeck’s truism: for the 2011 fiscal year, Idaho’s Medicaid program received about $1.55 billion in federal and state funding. That’s about a 20 percent increase from state fiscal year 2008, when combined state and federal funding totaled $1.29 billion. (For more on these numbers, see the Department of Health and Welfare’s Facts/Figures/Trends 2010-2011 and 2007-2008 reports.)
There’s one clear reason that costs have gone up even as state lawmakers have sharpened their pencils and focused on cuts. Enrollment in Idaho’s Medicaid program has ballooned in recent years. Between 2008 and 2011, Medicaid’s average monthly enrollment grew by nearly 21 percent, from 185,000 to 223,558. In the few years before that, enrollment was fairly stable, growing by 3.4 percent from 2006 to 2008.
The Idaho Legislature has made a serious effort to curb Medicaid spending. The most substantial cut, approved in the 2011 legislative session, totaled nearly $100 million in state and federal dollars. The Idaho Department of Health and Welfare has summarized the specifics of that cut. We here at StateImpact Idaho will have a broadcast story on its effects this Wednesday on KBSX 91.5.
