Idaho House passes 6.6% increase for 2023 Medicaid budget

[MM Curator Summary]: Idaho Medicaid spending has grown 100% in 10 years. The current budget requires $840M of state funds.


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Legislators have to finish setting the state budget to adjourn 


Legislators work from the House chamber at the Idaho Capitol on Jan. 17, 2022. (Otto Kitsinger for Idaho Capital Sun)

The Idaho House of Representatives passed the state’s largest budget of the year Tuesday, the Idaho Department of Health and Welfare’s 2023 Medicaid budget.

The budget includes a total of $4 billion in funding from all sources, which is a 6.6% increase from the current budget. About 70% of the money comes from federal funds, which total almost $2.8 billion. The budget includes $830 million in state general fund money. The rest comes from dedicated funding sources, such as the Millennium Fund, which was created with money from settlements from tobacco lawsuits. 

Medicaid is a state and federal program that provides free or low-cost health care to low income individuals and children who meet eligibility criteria. 


The budget, which is funded through House Bill 777, pays for 213 full time positions and provides $1.25 per hour per employee for merit-based pay increases. 

Rep. Paul Amador, the Coeur d’Alene Republican who sponsored the budget bill, said it is necessary to pay the state’s bills. 

“You will probably hear some debate about the unsustainability of Medicaid funding in Idaho, and I will not disagree with that,” Amador said during floor debate Tuesday. “This budget has ballooned over the last several years. But we are bound by our policies that are adopted in state statute at this time so we have to pay our bills, and this is essentially paying our bills for Medicaid for the next coming year.”

Some far-right conservatives in the House tried to kill the budget, pointing out its status as the state’s largest budget and calling it a windfall for the Idaho Department of Health and Welfare. 

“It is unsustainable at the rate we are going,” said Rep. Heather Scott, R-Blanchard. “I think we need to send a message by voting this bill down, resending it back and having it reworked.”

Rep. Ron Nate, R-Rexburg, said total funding for the Medicaid budget was just under $2 billion when he came to the Idaho Legislature in 2015

“The spending is clearly uncontainable. It has doubled in less than a decade,” Nate said during floor debate. “And let’s not forget that Medicaid is not sustainable without federal dollars. The federal government is on a path to financial ruin right now. What happens if the federal government can’t pay its bills?”

Since 2015, Idaho has been one of the fastest-growing states in the country, and Idaho voters voted to expand Medicaid eligibility in 2018. Medicaid expansion extended eligibility to about 100,000 additional low-income Idahoans under age 65.

Idaho began the legislative session with a projected state budget surplus of $1.9 billion.

Despite opposition by several conservatives, the Idaho House passed the budget bill by a vote of 43-27. The bill heads next to the Idaho Senate for consideration, where it will likely be taken up quickly. Legislative leaders are working to adjourn the 2022 session for the year on Friday.

Amador referenced how the Medicaid budget’s survival and passage is intertwined with the Legislature’s ability to adjourn, saying the state has to follow its laws and policies and pay the program’s bills.

“I appreciate your green light (of support); I’d like to go home this week,” Amador told legislators just before they voted Tuesday.


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