Proposed Medicaid cut could end meal deliveries for thousands of Idaho seniors

Originally published Jan. 20 on KTVB.COM.

Every weekday morning, over a hundred hot meals prepared by Metro Meals on Wheels arrive at a small nonprofit in Caldwell.

By 10:30 a.m., a team of volunteers at Caldwell Meals on Wheels loads up and fans out across the city to deliver them to seniors and vulnerable adults who often have no other way to get a nutritious meal.

"These folks count on these meals," said Julie Warwick, director of Caldwell Meals on Wheels. "They get one hot meal every day, which is something we all deserve."

The organization serves about 110 people in Caldwell each weekday and delivers frozen meals to another 40 clients in rural Caldwell, Middleton and Greenleaf once a week. About a third of them are on Medicaid and now, their meals are in jeopardy.

Gov. Brad Little's budget proposal for fiscal year 2027, which begins in October, calls for $45 million in Medicaid expenditure reductions, including the complete elimination of Medicaid funding for home- and community-based services as the state looks to close a $40 million budget gap this year. Meals on Wheels is a home- and community-based service.

In his 'Enduring Idaho' budget plan for FY27, cuts to Medicaid Little is proposing include:

"An additional reduction to hospital rates; an additional reduction to residential habilitation rates; removal of administrative costs for Managed Care contracts; removal of the pharmacy benefit for non-expansion adults on Medicaid; removal of adult dental services; removal of home and community based services; removal of physical, occupational, and speech therapy services; removal of case management support; removal of hospice services; removal of adult prosthetics and orthotics; removal of adult in-home nursing services; removal of adult chiropractic services; removal of adult audiology services; or removal of adult vision services."

"Those are simply not expendable," Warwick said. "I don't know what they would do without the meals."

The state currently reimburses Meals on Wheels providers $6.78 per meal, down from $7.06 after a 3% cut late last year. Warwick pays $6.50 per meal, leaving her just 28 cents to cover everything else: insurance, fuel, vehicle maintenance and all the other costs of running a nonprofit.

Under the governor's proposal, those reimbursements for the meals of Medicaid clients would disappear entirely.

Warwick said many of her Medicaid clients are homebound seniors.

"I've got a lot of veterans on the program," she said. "I've got a 99-year-old client. I've got two 95-year-old clients. These are not young folks that are, you know, kind of just looking for handouts. These are folks that have legitimately worked their entire lives, had something happen so that they are now disabled and cannot do what they need to do to be able to get a meal."

She also serves a handful of younger Medicaid clients, people with disabilities who are trying to live independently rather than go into long-term care.

"Having a meal every day helps them as well," Warwick said.

For all of her clients, Warwick said, the daily visit is about more than food.

"There are many that have been on 10 years or longer, so I've gotten to know them really well," she said. "Checking on them and making sure they're OK is also a vital part of this, and it doesn't cost a thing."

The nonprofit also runs a pet food program for clients who can't afford to feed their animals, and Warwick has even used grant money to help cover vet bills.

Mary Weber is one of the nonprofits clients on Medicaid. The Caldwell senior has relied on Meals on Wheels for years, and she said the program has improved her health.

"You eat food that's not good for you because it's cheaper and you can afford it. One meal a day that's good for you helps tremendously," she said.

The delivery is usually her only hot meal of the day.

Weber suffered a traumatic brain injury 25 years ago that has made it difficult to get around.

"I don't have a car, so I can't go to the store once a week to get vegetables and fruits and stuff, even then I can't afford it," she said.

The Meals on Wheels program has become her lifeline. She looks forward to seeing the volunteers every day and said the connection means as much as the food.

"Never a day goes that I don't thank them for, you know, taking the time out of their lives to show me a little joy," Weber said.

But the thought of losing the program is overwhelming.

"It's very stressful, and I don't do stress well," Weber said.

Her message to those looking to balance the state's budget is simple: look somewhere else.

"I don't feel important to them, and I haven't for a long time," she said. "Take a cut in your own pay, have programs that you know are being frauded. Take care of that," Weber said. "I don't see how they can look at themselves in the mirror and cut this program."

Warwick said her Medicaid clients represent just a small piece of a much larger picture. Programs like hers operate across the Treasure Valley, and a cut to Medicaid reimbursements would affect thousands of Idahoans who rely on the program.

"It's not one that should be cut," Warwick said.

The governor's proposed cut remains a proposal. But lawmakers will decide in the coming months what to cut and what to keep. Critics of the Joint Finance-Appropriations Committee (JFAC) process point to last year's historic tax cuts as a cut to revenue, which put Idaho in this position of having to cut Medicaid.

Other services facing cuts in the Medicaid budget include coverage for speech, occupational, and physical therapy for people on Medicaid.

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