By Ruth Brown, Idaho Reports
After lengthy debate Tuesday and compromised amendments, the Medicaid Managed Care Task Force is circulating a draft of its final recommendations and draft legislation.
As of Thursday afternoon, the report is not yet finalized, as task force members agreed to individually sign off on the final report over email.
The task force has been meeting since July, after the Legislature established the task force to address the growing Medicaid budget. In fiscal year 2024, the state appropriated $4.5 billion to the Medicaid budget, including half a million dollars to create the task force. The group began meeting in July, with stakeholders testifying and sharing insights at each meeting.
Task Force Co-Chair Sen. Julie Van Orden, R-Pingree, started by saying lawmakers are trying to be financially responsible.
“Contrary to some narrative that’s going on out there, I don’t think we’ve made any conclusions that Medicaid is not beneficial for our state,” Van Orden said. “We are not moving in a direction to remove Medicaid from the state of Idaho. We want to still serve the populations that need Medicaid and need assistance and we’re trying to find a way to make this an efficient system.”
The committee did approve a piece of draft legislation, in a 5-4 vote, that would establish an additional committee to review and discuss Medicaid throughout the year. Sen. Kevin Cook, R-Idaho Falls, Sen. Glenneda Zuiderveld, R-Twin Falls, Sen. Melissa Wintrow, D-Boise, and Rep. Nate Roberts, D-Pocatello, voted against the draft legislation.
Some members questioned whether the role of reviewing Medicaid should stay with the germane committees, or committees that consider policy.
“I just think our germane committees should be the experts at it,” Cook said in the meeting. “They should have all the knowledge. I’m not too thrilled on the idea of creating another committee. I realize that leaves me out in the cold, but I trust we have some pretty smart legislators in both the House and Senate germane committees, so I don’t think it’s needed.”
Van Orden, who chairs the Senate Health and Welfare Committee, disagreed.
“The reason I support this is because our germane committees meet once a year,” she said. “This committee would be meeting more than once a year. And I think it would be more than what we’ve had before. What I’ve heard from this committee is they want more structure and more times to have a look at what’s going on with our Medicaid program.”
Wintrow expressed concern that having another committee would push the Idaho Legislature toward a full-time legislature, pointing to the workload of the task force.
Other recommendations include that the germane Health and Welfare Committees, with input from value care organizations, managed care organizations, providers, and the Department of Health and Welfare, create “unique, but fair and reasonable, quality measurers based on best practices” for value care organizations and managed care organizations.
The task force declined to include some recommendations from Cook in its final report that would have required germane committees to review performance measurements of value care organizations and managed care organizations accepting Medicaid by the end of January of 2024, and potentially replace or reprimand organizations that didn’t meet standards.
Cook said he took issue with the report as written, and that’s why he prepared the amendments.
“(The report) makes the assumption that we as a committee made a decision, and I don’t think at this point we have,” Cook said.
The task force ultimately approved putting the draft legislation, which could establish a Medicaid legislative review panel, in its recommendations to the Legislature. The report from the task force, once finalized, will be submitted to the Legislature when lawmakers return in January.