The Idaho Legislature opened its 2024 session on Monday, January 8, and will likely run through late March. The state’s 35 senators and 70 representatives; led by the Senate President Pro Tempore Chuck Winder and the House Speaker Mike Moyle, will address many issues during this year’s legislative session including healthcare, education reform, and tax cuts.
Medicaid
After last year’s contentious debates during a constitutionally required five-year review of Medicaid expansion, lawmakers will revisit the state’s $4.5 billion Medicaid program. House Majority Leader Megan Blanksma has pointed to concerns over the program’s long-term sustainability and unpredictable federal contribution levels.
In November, Idaho’s Medicaid Managed Care Task Force decided to continue studying the state’s existing Medicaid program structure and what could be done to make it more efficient and cost-effective. The task force will deliver its final recommendations to the Legislature on January 31. Lawmakers are likely to act on the task force recommendations which may suggest continuing the state’s value-based care model or moving to a comprehensive managed care system.
Furthermore, lawmakers may consider potential cuts to Medicaid spending and increases to Medicaid reimbursement rates for certain types of providers, including direct care workers. Governor Brad Little has also proposed adding a work requirement for those who fall under expanded eligibility.
Currently, Indiana and Utah are the only states with federally approved and implemented Medicaid work requirements, although Utah has not reinstituted its requirement after a pandemic-related suspension.
Health and Human Services
Health and human services accounts for about 40% of the state’s annual budget. One of Rep. Blanksma’s top priorities this year is overhauling the Idaho Department of Health and Welfare (IDHW), citing such issues as an overwhelmed foster care system and overall structural inefficiencies. Additionally, Governor Little wants to increase funding for senior centers and meal delivery programs.
Last summer, U.S. Senator Mike Crapo proposed a framework to modernize and enhance federal prescription drug programs. State lawmakers may join his call to lower drug costs for Idaho patients by imposing new regulations on the practices of pharmacy benefit managers (PBMs) and implementing new price transparency measures.
Workforce Training
The Idaho LAUNCH Project; a program that awards grants to high school students so they can pursue training for in-demand careers such as nursing and physical therapy, is one of Gov. Little’s top priorities for 2024. He has proposed funding to award grants up to 10,000 students.
Additionally, Gov. Little’s Idaho Works plan includes $447,000 for eight new medical residency positions, further addressing the state’s physician shortage as part of the 10-year Graduate Medical Education plan.
K-12 Education
Lawmakers are likely to reexamine expanding school choice and voucher funding programs, potentially reshaping where students attend school.
In his Idaho Works plan, Gov. Little has also proposed the largest ever state investment in school facilities. Increasing funding by $200 million annually equating to $2 billion over the next 10 years. This investment will help school districts pay off bonds and levies, freeing up resources for future school infrastructure projects.
Taxes
Legislative leaders may look to cut property and income taxes further in 2024, following record tax cuts two years ago – including $250 million in permanent income tax reductions for individuals and businesses.
Infrastructure
Gov. Little’s proposed budget recommends $200 million to improve the final third of the state’s dilapidated bridges and $50 million to bond $800 million of other in-demand transportation projects. His plan also calls for $30 million to expand water quality stabilization efforts, adding to the state’s investment of $1 billion since 2019.
Social Issues
Amid ongoing legal challenges, lawmakers may tweak the state’s abortion laws, which currently only allow exceptions in instances of rape, incest, or threat to the mother’s life. They may also revive a maternal mortality review panel, which investigated deaths of pregnant women, and consider banning “obscene” materials from public libraries.
Budget Process
The Joint Finance-Appropriations Committee is expected to make significant changes to its annual budget-setting process. Instead of using massive omnibus spending bills, departments would submit requests through separate, smaller bills. Furthermore, departments would have to keep those requests collectively below agency budget spending caps, although the exact limits still need to be set.
Public hearings, which previously lasted three hours, would be replaced with sessions of 90 minutes of public input followed by 90 minutes of lawmaker workgroups. In addition, Idaho would launch a new online budget portal, promoting transparency and access to budget documents for committee members and the public.
