Those in charge of Idaho’s executive and legislative branches have a difficult time seeing beyond the end of their collective noses when it comes to funding programs important to Idahoans. All we have heard from the governor and the penny-pinching legislative leadership is “cut, cut, cut.” When times are tough, cuts may be needed to make ends meet. But, if you listen to the president and our governor, times are not tough. Both speak of how we are doing very well under their stewardship.
Governor Little continually touts Idaho’s strong and growing economy. In December, he proclaimed, “Idaho is # 1 nationally for wage growth – proving our economy is strong and moving forward!” One might wonder then, why we are in such a budget-cutting frenzy. It might be partly because he approved $300 million in tax cuts that he knew were ill-advised. Or, that he greenlighted the $50 million tax holiday for primarily well-healed folks who can already afford to send their kids to religious schools. Delaying the effective date of that tax give-away until next year would be an easy fix to the $40 million budget deficit for this year. A graduated tax increase would be a long-term fix.
The main budgeting problem with the MAGA folks running the state is that critical programs which serve large numbers of modest-means Idahoans are put on the chopping block without considering the long term effects. We may save a few bucks today but end up spending gobs more in the future to address the consequences.
The poster child for this type of short-sighted budgeting is Idaho’s Medicaid program.
With spending cuts, both those implemented and proposed by the Governor, future expenditures are certain to substantially eclipse the immediate savings.
The Idaho Sheriffs Association warned in December that cuts to behavioral health programs would likely increase future outlays for emergency medical services, incarceration and public safety. The Governor’s proposal to cut $45 million in Medicaid spending could result in the state getting $106.8 million less in federal funds next year.
This is just a small part of a much bigger picture of concern in the budgeting arena. The Big Beautiful Billionaire Bill (BBBB), passed with the votes of Idaho’s Congressional delegation, will cut Idaho Medicaid by $4.3 billion over the decade, starting next year. It will likely reduce our Medicaid roles by about 40,000. Combined with whatever cuts are made by Idaho’s government, the impact on Idahoans are likely to be catastrophic.
Like it or not, Medicaid funding is the lifeblood of Idaho hospitals, particularly those in the rural areas of the state. The tremendous reduction in federal funds, combined with cuts made by the Governor and MAGA legislators, will imperil the existence of rural hospitals already on the brink. The piddly $100 million provided to the state in the BBBB will not suffice to fill the gap.
The MAGA legislators are clamoring for the repeal of Medicaid expansion that was approved by over 60% of Idaho voters in 2018. It covers about 90,000 Idahoans. Repeal would deal a hammer blow to our already-endangered rural hospitals, not to mention the damage inflicted on sick Idahoans. We get $9 dollars in federal funds for every $1 in state funding. That results in about $1 billion invested into Idaho health care.
Substantial cuts to Medicaid funding would be completely counter to another priority of some reasonable legislators who are trying to remedy Idaho’s chronic shortage of healthcare providers. Idaho ranks lowest in the nation for both doctors and nurses on a per capita basis. The lawmakers tell us that 1,400 additional medical professionals are needed to catch up to the national average. That simply can’t happen unless substantial funds are forthcoming. Idaho’s 4% cut in Medicaid reimbursement for doctors certainly won’t help. Idaho simply can’t attract the necessary healthcare workers to serve our rural areas by short-changing them. With the state’s unfriendly attitude toward doctors, there is already a stiff headwind to overcome.
Numerous headlines expand upon Idaho’s short-sighted approach to medical funding: “Idaho Medicaid cuts for nursing homes are unsustainable”
“Proposed Medicaid cut could end meal deliveries for thousands of Idaho seniors”
“Idaho Medicaid cuts could force disability providers to close”
“Idaho Medicaid contractor to cut critical services for people with severe mental illness”
This is just a sampling of the penny-wise, pound-foolish approach of those currently in power in Idaho. There are many reasonable and pragmatic legislators in the GOP ranks who try to work across the aisle with Democrats to move the state forward in a rational fashion. They need the support of Idahoans of good faith who will speak out at the ballot box.