Idaho’s Medicaid Program by the Numbers
To understand the challenges Idaho’s Medicaid program has faced in recent years, it’s important to understand the numbers. As we noted in earlier reporting, Medicaid enrollment has grown by more than 20 percent since 2008.
Source: Idaho Department of Health and Welfare
The result is greater spending. As the graph below illustrates, state Medicaid expenditures peaked in the 2011 fiscal year, which ended in June. That peak came just after the state saw Medicaid enrollment increase by more than 9 percent from 2009 to 2010. It was the largest increase the program had seen in eight years.
Source: Idaho Department of Health and Welfare
However, in 2011, the year when total Medicaid spending reached its highest point, the state actually spent less than it had in 2008 — $356 million as opposed to $371 million. That’s because the American Recovery and Reinvestment Act temporarily increased the federal match rate, lowering state expenditures.
Medicaid is, of course, a partnership of federal and state government. Historically, the federal government has footed about 70 percent of the Idaho Medicaid program’s payments to providers. That rate began to rise in October of 2008, and in state fiscal year 2010 it topped 79 percent. The heightened federal contribution came to an end in June of this year. That set the stage for the funding discussion that ultimately resulted in about $35 million in state cuts last legislative session.
Source: Idaho Department of Health and Welfare
The American Recovery and Reinvestment Act (ARRA) stipulated that states receiving an increased federal match could not make changes to reduce eligibility. That leaves reduced reimbursement rates, higher co-pays, and service cuts as primary means for cutting spending.
For more information about the temporary Medicaid funding changes that resulted from the ARRA, see the Idaho Department of Health and Welfare’s Fact/Figures/Trends 2010-2011 report.