Senator Julie VanOrden-representing District 31 in Seat B

Here we have Idaho is sponsored by First Class Cleaning, Tom Luna and Victor Miller.

Welcome to Here We Have Idaho. A local show focused on celebrating Idaho and all it makes Idaho

great. Here we have Idaho will highlight important issues and events that impact Idaho's

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there's truly one state in this great land of ours where ideals can be realized.

The pioneers made it so for you and me, the legacy will always thrive. Here are your hosts,

Victor Miller and Tom Luna. Good afternoon and welcome to another episode of Here We Have Idaho.

We're just so grateful that you're joining us today. I'm Victor Miller, one of the cohosts.

My other cohost, Tom Luna, is not here this week, but he sends a warm hello to everyone.

And we just thank you again for joining us on Here We Have Idaho. And today we are really grateful

to have Senator Julie Van Orden join our show. And just a little bit about Senator Van Orden.

She's representing Legislative District 30. She's in her third term, although she did also serve

three terms in the House from 2012 to 2018. So she's been here for six total terms. She's a lifelong

resident of Idaho and Bingham County. She's graduated a Blackfoot High School and ISU Vocational

Technical Education. She's co-owner of Garth Van Orden Farms. She's a former commissioner on the

Idaho Public Charter School Commission and the Idaho Potato Commission. And her awesome husband

is named Garth and they have four children, two daughters-in-law, three grandchildren,

he's still up three or do you have more now? I have three and one, a great granddaughter. Whoa,

that's not your bio. You got to update the bio. That's crazy. Oh, you do. Yes, Luna is your... Yes,

there you go. And Tom Luna is the host cohost. So there you go. Cool. Not named after Tom, I imagine.

Anyway, she's on the health and welfare. She's the chair of that in the Senate. And she's also

on Agriculture Affairs and Resources and Environment. So thank you for joining us on here. We have Idaho,

Senator Julie Van Orden. Thank you for having me. It's nice to be able to interview on the radio.

I like it so much better than Bingham TV. Yeah, right. It's a much different element, right?

So we're going to talk pretty much about health and welfare issues because you're the chair there

in the Senate. And it's gotten a lot of attention over the last few years. You can arguably say,

since Medicaid expansion came in, it's been a top burner issue. So why don't we first talk about

Medicaid expansion and how Idaho became... How that came into being in Idaho. Let's start and set

the foundation of this conversation. So take us back to the Miss of Time 2018. Well, it was...

I will tell you that I was in the House then. And while my care had come in to play on a federal level,

with all of that, there... And the requirements in that had left people in our state in what

they'd be called the gap. So Medicaid, if you remember, everybody was required to have insurance.

Right. So there was this gap of people that were... that couldn't get on Medicaid because they made

too much. And then they couldn't get on the exchange to get a subsidy to buy insurance on the

exchange, but they... And they didn't have enough money to buy insurance. So that kind of left them

in this gap. So I remember for two years when I was in the House before 2018, the speaker of the

House then got bad key would come around and... And they were trying to work out a solution for

these gap people. And so he would come around, I have this proposal. What do you think? And so he

was telling votes to see what kind of votes he could get through the body on different proposals

like that forward. Two years, he worked on that. So when I got beaten in election in 2018, but

when that initiative passed, I was not surprised because we had tried to work on it for a couple

years. And the bodies in this, you know, in this building, they could not come to any agreement

on how to take care of this issue. So when the citizens took it upon themselves and ran that initiative,

I wasn't surprised that it passed because you knew there were a lot of people that were being

affected by this. And so... And the citizens of Idaho took it upon themselves to deal with it.

Right, so what through the initiative, right? Yeah, so what through the initiative process?

And it was like 70% 30, something like that. Yes, it was passed by quite a bit. And in my legislative

district, it was passed by I think 60%. Okay. So it was significant. And so that's where Medicaid

expansion came from. The numbers that we were given by the actuaries when at first, when they first

proposed it were pretty small, you know, it was like a smaller amount, much smaller than we're paying

right now for Medicaid expansion. I don't think we realized how ill our population was and then

COVID hit. Right. And during COVID, we were not able to adjust roles, right? Right. You had to just

keep taking people on. You couldn't do re-determinations to determine if they were eligible or not. So

it grew substantially then too. And so... And the people coming on were a lot more ill, I think,

than we thought. And so they were high users of the service. So I think that's why... And then we

had population growth too. And so I think that's another reason why the numbers and the usage went up.

And so it's become a, I don't know, six, five point something billion dollar bill for us now.

And granted, with that, we have a... We pay 10% in the federal government, paid 90% of that bill.

But it's still that to have the growth that it was having at the time, it was half a billion dollars of

growth every year, that we were having to find to supplement, to address the cost of this.

And just for context, the total health and welfare budget in 2018 was 736 million. And that's two

pieces, the health and welfare department, and then the division of Medicaid combined. Now that

number is in 2026 is expected to be 1.229 billion. So that's an increase of 523 million dollars

in a very short amount of time. And most of that driven by the Medicaid side. So let's talk a little

about the roles as you talk about it. The roles... Who is this program intended to help?

And when you talk about the roles, you know, people that have enrolled into this,

talk about how you've been trying to deal with managing the amount of people

that are... So that we can... The cost has been an issue, obviously we're in a down budget year.

Just talk about that general. What was the intent of who Medicaid expansion was supposed to help?

And how can we try to best manage the... So that we're actually serving the right people in this?

Medicaid expansion was originally... And I think it still is. It's helping what they call

working poor. So people that, like I said, don't make too much to go on Medicaid, but are struggling,

yes, to get insurance, basically. And those are people that have jobs. They're working, but they

just don't make enough. There are also elderly and disabled people that are on Medicaid expansion,

also, I believe. And some of the ways that we would like to address it, and the federal government

evidently agreed with this. So last session, we passed health bill 345 that put in place the

requirement for... Work? Work. Work or volunteering? You could do volunteering. Yes, but you had to do a

significant amount of that, of volunteering, to qualify as work. So that's one of...

And I believe that was 20 hours, is that right? Yes. Okay. So, and the other piece to that was

we put in what's called cost sharing. And that would be a shared cost, like a copay.

And then the other thing we put in place would be checking twice a year on eligibility for

these individuals. So right now, we only check once. This would be twice a year that the department

would have to check on eligibility for individuals. And, you know, it rotates. But we felt like those

pieces were pieces that would address some of that. The work requirement was huge, I think.

And the federal government came back with the big, beautiful bill and put those pieces in place too.

Yeah, Idaho tends to lead in a lot of things too. And also in the big, beautiful bill, you know,

restfulcher had the no tax on overtime elements. So Idaho leads. I think so. So let's talk about,

I'm going to talk about the eligibility, the checking on eligibility twice a year. What are you

checking for to make sure that people are not taking advantage of the Medicaid and the roles are not

inflated unnecessarily? Well, there are a number of things that we check. But one of the things that I

will tell you, I'll go down kind of a different path here. Yeah, please. We want to be able to check.

And this is kind of an interesting thing. And I don't know how we'll do this. But people's assets,

because there are people that move here that retire or, you know, they've invested in a lot of

things. So when you look at their income, their income is quite low. Right. And, but yet,

they are, they're, yeah, they have, they have means. Right. And yet they're on Medicaid. And so

the whole kind of issues are the ones that I think that are some of them that we want to look at.

People that also are not taking jobs because it would bump them up over that threshold. So,

so we want to check on those things and make sure that we're serving the people that actually need

that's everybody's intention to be able to do that. And it's interesting. I just was on a call with

a couple of my colleagues from the house for a chamber. And one of them helps people, you know,

with their insurance needs. And he said, you know, Medicaid doesn't cost the state anything

until people use it. Right. And that's true. That's true. So that's another little

and, you know, informational fact to have out there. And I don't know how we incentivize

or disincentivize the use of it. Right. But we're looking, we're looking at the co-pays would be one

thing, I think. But just making sure that people are doing the things that they're doing and

not abusing the system. And then we are capturing the people that actually need it.

So let's talk a little about let's frame what's happening this year, the reality of the state

budget. Right. So in 2025, the governor didn't did an executive order called the Idaho Act,

which cut 3% across the board, except for education. And this year, the J-FAC joint finance

appropriations committee is recommending an additional 1% for the fiscal year 2026,

an additional 2% for fiscal year 2027. So that would be 4% in 26, 5% reduction in 2027.

So one of the thoughts that I know Chairman Van der Wauda, who is the Chairman of Health

and Welfare in the House, he's been thinking of drafting a bill which would basically sunset

the current Medicaid expansion program every year, I believe, and essentially would allow,

would make people basically reapply your thoughts on that legislation.

Um, I think that's a, I, I'd like it because it's kind of a reset, reset and every year,

let's reset this thing and revisit it. Um, I think that it's, it's kind of like somebody

checking on you twice a year. Right. And now they're going to be checking on you every year and

making sure. And it's interesting though, Victor, that I see people that come, they complain

about it. And they're like, why, why are you doing this? It's like, this is state money

or giving, you know, and so we need to have checks on this. And I think that checks are,

are good, are a good deal. The other part of Chairman Van der Wauda's proposal that he would

like to see happen is that there's a cap on the number that we serve under this

under Medicaid expansion. He would like to see it be, I think he said 60,000 people.

Right now, I think we're upward of 70, 70, 75,000. Um, and he said, because

there, that we put a cap on, they would not be eligible to get on the exchange. So they would

be eligible to go to the, or they would not be able to get on Medicaid, but they would be able

to qualify for a subsidy for the exchange. Because right now, if you're qualified for

Medicaid expansion, you don't qualify there. So it would qualify them. And so they would be

able to get that subsidy and get the insurance. And just right now, the subsidy, what does that

come from another bucket of money within health and welfare? Is that a federal program

as a state program? I believe it's a federal program. A federal program? Okay.

So another topic, of course, has been the way in which the budgets are being done this year,

right? So some are, some are in the camp that, you know, cross the board, cuts are easy because

it puts the same burden on, on every agency. Some people have said, you know, it'd probably

better if it was a scalpel because there are some agencies that have been doing really well

in stewarding their finances. And we'd be punishing them by hurting them as much as some of the

agencies that may be running, not as lean. Where do you fall into that camp and where do you think

health and welfare fits into that? Do you think it's fair that that health and welfare should bear

the same burden as every other state agency in terms of the cuts? What's your thoughts?

Oh, that's a hard question. I think I'm in a camp where we should take a scalpel because I know,

I worked, I was on J-facts, so I got to see a lot of those budgets. I worked the health and

welfare budget and the education budgets, both K-12 and higher ed. That's not even at the same time

and I was chairing a committee over here too at the same time. So it was a lot of work. I loved it

because it kept me busy. Right. But I think the scalpel approach, I believe, is better just because

right now. So not across the board cut you'd like to see. No, okay. And to me, I would rather vote

on a budget that's been looked at in depth. So it's really difficult to vote on these budgets right

now that the base budgets have been hit by the rescission. So the cuts that were made in 2026

and the legislature. So that the base budgets that are coming through now have been hit with those.

There are some supplemental budgets that are working their way through right now too,

that I know J-facts have been working on that add some of those things back in or cut in the rescission.

But I don't know if those are going to pass. So can we just do a base budget that's been

actually worked on? It's sifted. Yes. But when it's hard to do because you might have

a number of agencies within those big budgets. Right. And there's over a hundred agencies.

So it's a lot of work. Yes. So you're in those base budgets, you're voting in this big chunk.

You know, you're voting for all these budgets that have been cut and you don't know what's

going to come in the supplemental. So for example, I just voted on too much yesterday. One was

the natural resources budget. I voted for that. Make sure that the 30 million for all of the

projects that we the 30 million dollars that we had put in code last year to go to

water projects. I'm not for recharging things like that. I wanted to make sure those were in there

that that was in there and had not been cut and it had not. So I felt comfortable voting for that

budget. Right. The next budget that came through was public safety. What had been taken out of

that in the in the straight across the board cuts were salaries for state troopers, you know,

the the money to higher state troopers. And so I wasn't comfortable voting for that budget

because I felt like I don't know if those were going to come back. And I would rather have them

be in that budget. Right. And public safety obviously is a number one issue for all Idahoans

and most Americans. It is. Yeah. And so I'm voted against that one. So we'll see what comes through

in these rescission budgets. It's it's been interesting. When they did split the budgets way back

it's been one two years ago. They split them out into because before we would vote for

entire budgets. Right. And it was like health and welfare budget, this division and the

supplementals that went along with it. Right. And you can vote up or down. Well, people felt like I

think they they were getting creamed when they went home and they voted against an education budget

that they didn't like. Right. And so they went home and they got hit in campaigns with

you don't support education. Right. So they split them. So now you can vote for the base budget

in education and go home and say I support education. Right. But any supplementals that come along

now you can vote against them. So you can go home and say I support education but I don't support

adding this much more onto your budget. Gotcha. I don't know if that's you know I can see one way

or the other but it was a lot easier to see those budgets and how they look when they come

as a budget bill to us. In totality you liked it better that way. Yeah, because you got to see

here's the budget, the base budget, and then here's the supplementals. So you could see the whole

thing and move through. But it's you can. I mean it is it is it is an experiment. It's two years

already we've done budgets this way. And the the proponents would say that it's actually

helped restrain the growth in government. And so in the and the other side the other

can. Yeah, the other cap is saying that yeah it was easier to understand when I got the whole

budget at once. So we'll have to see how that goes but it is what it is right now we get

them we have a maintenance budget that's brought and then supplemental budgets two different

budgets. So let's talk about how health and welfare your committee and since and representative

Vanderwoud is committee when the health and welfare budget is going to come up. Does your committee

get to get a preview to like the does the health and welfare department come to your committee say

hey here's what we're thinking about bringing to jfak the joint finance appropriations committee

give us a first blush what you're thinking like how are you guys involved kind of in the pre

budget discussions if at all and would you like to be if you're not?

Traditionally before now the the

um germane committees have not been involved in the budgeting process

as with the agencies that they basically they have come into them. I more and more I think

it's becoming more important for them and the last two years we've had the budget

analysts from um legislative services office jfak and jfak come in and talk to us about

different aspects of the budget but of course they give you a pretty high view of them

it's not like being there and working on those budgets. I've had some of the members ask if

there's any way that we can start being more involved in that. I know in other states they actually

have the germane committees address that so not only are you dealing with policy but you're

dealing with the budget for that agency too which is kind of an interesting thing other states have

their separate committees so they have your policy committee over here that deals with health

and welfare issues and then they have a whole nother committee that is actually a committee that

deals with the budget for that health and welfare in this case and what do you would you do you

think it would be helpful if the germane committees were more involved in kind of the pre pre-budgeting

work before it's presented to jfak for example um like what is your what what is your got tell you

we get the opportunity now as chairman of the committee to go into jfak and address

that budget health welfare budget so we get the opportunity to go in and talk to the committee

about the budget um we do ahead of time chairman van der Watt it does it different

but i just asked my committee please look through that budget if you have any questions let's talk

about it um and then kind of give me your opinion so i can write up some notes when i go in

to address jfak about that it would it would be nice if we could um

delve into the budget a little more the the only thing is if you look at these germane committees

ours is a perfect example of we would be just health and welfare but right it's very it overlaps

perfectly yes but then like our natural resources committee there's department of lands department

of you know all these different right and department of water resources yes you would have all of

those that they would have to look through a lot of budgets that's a lot of budgets right a committee

like that right and so i don't know how that would work here i think the way we're doing it now

and this year is the first year that the co-chairs of jfak have asked if they can come into the

germane committees and talk about the budget that's a good thing so um i i think it was hard

forum to go into like the resources to be at department of water resources budget you know

when some other budgets that they were working on um but they did come in this year and talk

about those budgets so we have about we have about two minutes so just quickly on the budget for

2026 2027 the department of health and human resources 2026 was about 235 million dollars

jfak is looking at 211 million the governor wanted 224 million so a little bit more of a cut

from jfak division of Medicaid 2026 994 million jfak is looking at 971 and the governor wanted

1.047 billion so there's about a 70 about 70 million dollar difference between the governor and

jfak they're on on division of Medicaid there's a bill house bill 759 senate bill 1312 which was

brought to increase transparency for taxpayers and support appropriation reductions for Medicaid

rates paid to residential bill attation providers do you want to talk about that um that bill and

whether you whether you support it um i support the bill it was um there's so many

different nuances to a bill like that um and that you just can't see in what's printed right

um there was simplifies it too much there was a lawsuit that came um a number of years ago that

it was called the kw lawsuit okay and so there were some nuances that came at that that

are that would address that the 20 million dollars that is being um removed from that budget so

right we're trying to deal with that put some transparency on um the res have facilities in

themselves and their finances so stay tuned stay tuned so that has not made it through has that

made it through the house and the senate yet or is that still it's on the house floor house floor

okay and you expect that to pass through the house floor i expected to okay and that would be

about a 20 million dollar reduction in the health health and welfare budget thank you

one of the governors well health and welfare and the governor's recommendations okay thank you so

much hey um thank you again so much for listening everyone to here we have Idaho and we've been

the distinct pleasure of having senator julie van orden join us again she's from

representing district 30 she's in her third-term although she did serve three more

terms in the house and we're just grateful for your chairmanship and your leadership of the

health and welfare a very tough committee but we're grateful that you are at the leadership of it

and uh thank you for joining us on here we have Idaho and as we always say before we sign off

god bless the great state of Idaho and thank you again senator julie van orden thank you

thank you for joining us today on here we have Idaho we hope you enjoyed today's show

and we look forward to visiting with you for a half hour each wednesday and friday at 4 p.m. on

kspd 790 a.m. and 94.5 fm till next time god bless the great state of Idaho