AP NEWS

Legislation on Medicaid expansion advances in House, Senate

March 20, 2019

BOISE, Idaho (AP) — Two pieces of legislation putting work and other requirements on the voter-approved Medicaid expansion in Idaho advanced on Wednesday in both the House and Senate.

On the House side, the House Health and Welfare Committee voted 10-3 to send to the full House a bill put forward by Republican Rep. John Vander Woude.

In addition to a 20-hour-per-week work minimum, the bill would require people who are between 100 and 138 percent of the federal poverty level to continue paying for private insurance on the state-run health exchange. That requirement would only be lifted if the state fails to get federal approval for the plan by the start of next year, in which case those individuals would be moved to Medicaid coverage.

On the Senate side, the Senate State Affairs Committee approved holding a public hearing for a bill put forward by Republican Sen. Fred Martin.

The first section of that bill directs the Idaho Department of Health and Welfare to look into the possibility of the federal government rather than the state paying for care of some people with mental health issues. The second section seeks to make sure all individuals eligible for Medicaid have access to work or job training.

The third section would allow Idaho lawmakers to nullify the voter-approved Medicaid expansion for a number of reasons, including if the federal funding falls below 90 percent.

Voters authorized Medicaid expansion with an initiative that passed with 61 percent in November after years of inaction by the Idaho Legislature. The expansion will provide access to preventative health care services for about 91,000 low-income Idaho residents, according to a risk management company hired by the state. The federal government would cover 90 percent of the estimated $400 million cost.

But many Republican lawmakers in the Republican-dominated Legislature still oppose Medicaid expansion. Among their concerns are potential costs and what they have said could be an incentive for people not to work.

“I don’t mind helping the working poor,” Vander Woude told lawmakers at the start of the House committee meeting. “For somebody who is not working, it’s a little bit different ballgame for me.”

Representatives, senators and the officials with governor’s office have been meeting for weeks to determine what kind of legislation could be approved by both chambers and Gov. Brad Little, a Republican.

It’s not clear if the two pieces of legislation that moved ahead Wednesday create the right balance to do that.

Dozens of people testified Wednesday at the House committee meeting, overwhelmingly voicing opposition to the legislation.

But Idaho would not be the first state where added recipient requirements have been considered. Utah passed sweeping changes to a voter-approved Medicaid expansion earlier this year, cutting the number of people covered nearly in half and adding work requirements.

In general, those opposed to changing the Idaho initiative say it goes against the will of the voters and will cost the state money on a number of fronts. That includes administering the work and other requirements, as well as counties having to pay for the costs of caring for those who end up not covered under Medicaid but still use emergency medical services.

“I would consider this a gutting of what the people passed,” Democratic Rep. Ilana Rubel during debate in the House committee hearing.

Idaho’s Medicaid expansion has already survived several challenges. Last month, the same House Health and Welfare Committee killed two pieces of legislation intended to repeal the expansion.

Also last month, the state Supreme Court upheld the voter-approved initiative for Medicaid expansion following a challenge from a conservative group that argued it was unconstitutional.