HEALTHCARE-ID

Cindy J. Carlson

This bill imposes a litany of new regulations on pharmacy benefit managers (PBMs) which are largely designed to benefit local pharmacies. For example, PBMs must now use "pass-through pricing" instead of "spread pricing" systems, pass along 100% of any drug manufacture rebate, and limit patient steering among other provisions. Oppose is the Limited Government Position as the nation witnessed first-hand the disastrous consequences and cost of growing government regulatory power in healthcare (i.e. Obamacare). Instead of working to promote a freer market through regulatory reduction, lawmakers added a series of new layers of regulations through this measure, including utilizing government to provide local pharmacies with more favorable outcomes in their private contract negotiations with PBMs.

Growing Government Regulatory Power within the Pharmaceutical Industry by Imposing New Mandates on Pharmacy Benefit Managers to Benefit Local Pharmacies.

This bill prohibits the Department of Health and Welfare from seeking or implementing new Medicaid (government-provided healthcare) state plan amendments or waivers that would expand coverage or increase any cost to the state without explicit legislative authority. Support is the Limited Government Position as this bill reduces government dependency and helps protects taxpayers from runaway spending under the state's Medicaid welfare program.

Protecting Taxpayers from Ballooning Medicaid Welfare Spending by Requiring Legislative Approval for Expansion.

This bill extends the duration of postpartum coverage provided Medicaid (government-provided healthcare) from 60 days to 1 year. Oppose is the Limited Government Position as this bill further grows government dependency under the state's Medicaid welfare program. The state must pursue every available avenue to rein in its out-of-control spending, which, when coupled with the over $185 trillion in federal liabilities, represents the greatest existential threat facing this country.

Increasing Government Dependency and Ballooning Medicaid Welfare Spending by Hiking Postpartum Coverage from 60 Days to 12 Months.

This bill allows mental and behavioral health providers who are licensed in other states to provide services in Idaho through "telehealth" (utilizing the internet or video call to provide diagnoses and prescribe medication). Support is the Limited Government Position as this bill reduces the shortage of mental and behavioral health providers and improves the ability of patients to receive attentive and timely treatment.

Expanding Competition and Availability of Mental Health Services by Allowing Providers in Other States to Provide Services Through Telehealth.

This bill appropriates over $4.7 billion to the Department of Health and Welfare for the state's Medicaid system which it expanded under Obamacare. Spending has grown by over 33.8% in the last three years, and this bill would authorize the creation of 24.5 additional full-time positions to expand administrative overhead within the department. Oppose is the Limited Government Position as this bill further grows government dependency and wasteful spending within the state's Medicaid welfare program The state must pursue every available avenue to reign in its out-of-control spending, which, when coupled with the over $185 trillion in federal liabilities, represents the greatest existential threat facing this country.

Increasing Government Dependency and Fueling Out-of-Control Spending Through an Over $4.7 Billion Appropriation for the State's Expanded Medicaid System under Obamacare.

This bill creates a new "state directed payment" program under the state's Medicaid welfare program which was expanded under Obamacare. The bill ultimately results in higher payments to hospitals and healthcare providers by gaming the federal Medicaid system. . Oppose is the Limited Government Position as this bill further grows out of control Medicaid spending and places the state at even greater dependency on federal funds - a significant liability if federal funding is cut. The state and federal government must work to shrink the Medicaid system. The out of control spending, when coupled with the over $185 trillion in existing federal liabilities, represents the greatest existential threat facing this country.

Growing Medicaid Spending Under Obamacare Through a New "State Directed Payment" Scheme to Hospitals which Games the System to Extract Additional Federal Funds.

This bill provides the Director of the Department of Insurance new power to impose large penalties on pharmacy benefit managers (PBMs) for any violation of regulations the state enacted in 2020. These regulations control prices and contract provisions negotiated between PBMs and local pharmacies. Oppose is the Limited Government Position as the nation witnessed first-hand the disastrous consequences and cost of growing government regulatory power in healthcare (i.e., Obamacare). Instead of working to promote a freer market through regulatory reduction, lawmakers added a series of new mandates in 2020 which utilized government power to provide local pharmacies with more favorable outcomes in their private contract negotiations with PBMs. This bill merely further worsens the government overreach by subjecting PBMS to significant penalties for any violation.

Providing Government Bureaucrats New Powers to Enforce Overreaching Regulations Recently Imposed on Pharmacy Benefit Managers (PBMS).

This bill appropriates over $4.5 billion to fund the state's Medicaid system which was expanded under Obamacare. This appropriation represents an over 58% increase in spending within the past 3 years and includes additional covered services for recipients and higher reimbursement rates for providers under the welfare program. While this appropriation is $150 million less than another Medicaid budget proposed this session (H 334), it is still $829 million higher than other proposals which account for the removal of 75,000 individuals who are receiving benefits but are not eligible for the program. According to the Federal Centers for Medicare and Medicaid Services, Idaho has one of the highest rates of improper Medicaid payment in the nation - a staggering 39.8% in 2019. Oppose is the Limited Government Position as this bill further grows government dependency under the state's Medicaid welfare program by growing benefits and failing to remove ineligible recipients. The state must pursue every available avenue to reign in its out-of-control spending, which, when coupled with the over $185 trillion federal liabilities, represents the greatest existential threat facing this country. Democratic lawmakers who voted against the bill due to the lower appropriation compared to HB 334 were recorded as opposing the limited government position.

Increasing Government Dependency and Fueling Out-Of-Control Spending through a $4.5 Billion Appropriation for the State Medicaid System Under Obamacare.

This bill establishes a new health insurance mandate which requires most healthcare policies offered in the state that cover prescription contraceptive drugs to cover a 6-month supply of the drugs. Oppose is the Limited Government Position as each and every health insurance mandate or price control on co-payments prevents an individual or business from selecting a plan with just basic or customized coverages to fit their specific needs. As a result, health insurers are forced to only offer costly plans loaded with coverages that most individuals do not need. This can result in lower-income or younger individuals choosing to purchase no insurance plan at all due to the high cost.

Year	Hospitals and Facilities	Insurance	Medicaid	Pharmaceuticals	Physicians and Providers
2024	100	100	100	100	0
2023	0	0	100	100	100