Idaho budget committee rejects governor’s request to expand physician recruitment program

The Idaho State Capitol building on Jan. 23, 2024 in Boise. (Otto Kitsinger for Idaho Capital Sun)

With Idaho ranking at or near the bottom nationally in terms of doctors per capita, the Idaho Legislature’s powerful budget committee on Wednesday zeroed out a $500,000 request from Gov. Brad Little to expand a popular program that helps doctors who practice in Idaho communities that are facing a shortage of medical professionals repay their medical school debt.

This year, Little requested an additional $500,000 to expand the Rural Physician Incentive Program, which provides $25,000 a year to help physicians who provide medical care in federally-recognized Health Professional Shortage Areas in Idaho repay their academic debt. Idaho physicians may participate in the program for four years, receiving a maximum of $100,000.

At a time where most of Idaho is officially designated as a Health Provider Shortage Area, the $500,000 would have provided enough money for five additional physicians working in underserved communities. 

Susie Keller, CEO of the Idaho Medical Association, told the Idaho Capital Sun on Wednesday the Rural Physician Incentive Program is a valuable tool to help the state recruit and retain doctors.

Keller told the Sun that Idaho ranks 50th nationally when it comes to the physician-to-population ratio. Keller said some of that is due to the rapid growth Idaho has experienced over the past decade or more. But Keller said some of the shortage has to do with what she described as a pipeline for physicians practicing in Idaho. The pipeline includes K-12 public schools, colleges, medical schools, residency training, recruitment and retention.

Keller chairs the board that evaluates applications for the Rural Physicians Incentive Program, and she said the program is an important part of the recruitment and retention portion of the pipeline she described.

In their applications, physicians make compelling cases for doctors making an impact in their communities, she said.

“But with the committee it has always been the case that we have more applications for loan repayment assistance than we have funds available to award them,” Keller told the Sun.

The loan repayment program exists in Idaho state law and has been around more than a decade, but it requires funding from the Idaho Legislature.

Since 2013, 98 Idaho physicians have participated in the program, and 83% of them are still in Idaho, according to numbers from the state.

The $500,000 request to expand the repayment program went before the Idaho Legislature’s Joint Finance-Appropriations Committee, or JFAC, on Wednesday morning at the Idaho State Capitol in Boise.

JFAC is a powerful legislative committee that meets almost every day and sets the budgets for every state agency and every state department. 

Rep. Josh Tanner, a Republican from Eagle who serves as assistant majority leader on the House Republican leadership team, made the motion to pass the Idaho Department of Health and Welfare’s fiscal year 2026 public health services budget enhancements with $0 funding for Little’s $500,000 request to expand the physicians loan repayment program.

Tanner said he wanted to point out the loan repayment program benefits some of the most high net worth people in the state. 

Tanner also said he favors a medical residency program and pointed out Idaho participates in the Washington, Wyoming, Alaska, Montana and Idaho, or WWAMI, cooperative education program.

At about the same time Tanner led the effort to zero out funding for the medical school repayment program, the House Education Committee passed House Bill 368, which scales back Idaho’s participation in the WWAMI program, Idaho Education News reported.

“Where is enough enough within some of these programs?” Tanner said. “And if we were going to focus on one, I would want to focus on residency and not a loan repayment program.”

Rep. Rod Furniss, R-Rigby, made an unsuccessful effort to approve Little’s $500,000 request to expand the physician’s loan repayment program Wednesday.

“Just so we know, Idaho ranks 50th of 50 states in active physicians per capita,” Furniss said during Wednesday’s JFAC meeting. 

“The more doctors we have in Idaho, it helps keep insurance costs down. It gives our people better care,” Furniss added. “One of the problems we have in Idaho is access, and I would hope you would see the value of this program. It’s helped many physicians stay in Idaho.”

Under the program, Idaho physicians providing primary care medicine, family medicine, internal medicine and pediatric medicine are eligible to participate.

The move to zero out funding to expand the physicians loan repayment programs comes on the heels of the Idaho Legislature approving record levels of tax cuts, which reduce the amount of revenue the state has available to spend in its budget. 

On March 6, Little signed into law House Bill 40, which reduces individual and corporate income tax rates from 5.695% to 5.3% at a cost of $250 million per year in state revenue.

The Idaho House and Idaho Senate have both passed House Bill 231, which increases the grocery tax credit Idahoans receive each year to offset the sales tax on food by $35 per year for most Idahoans, at a cost of $50 million per year in state revenue.

Little also signed House Bill 93, which provides a refundable tax credit to reimburse Idaho families for education expenses, including tuition at private religious schools, at a cost of $50 million per year in state revenue.