Idaho Republican Lawmakers Say They'll Rethink Medicaid Expansion Tweaks

Mar 8, 2019

Dozens of people turned out Friday to defend Idaho’s voter-approved Medicaid expansion against modification. That seems to have given lawmakers pause – at least for now.

Rep. John Vander Woude (R-Nampa) is sponsoring a bill that would tack on certain restrictions, like work requirements, if enacted.

“Don’t think you haven’t been heard and we haven’t been listening. We have,” Vander Woude says.

Requiring those enrolled under the expansion to work, volunteer or go to school for at least 20 hours a week, he says, is still on the table. But he wouldn’t comment on which parts of the bill may get tweaked over the weekend.

“Whatever gets drafted, we’ll take into consideration the testimony that we got today and so hopefully there won’t be the need to have everybody come back again and testify again,” Vander Woude says.

Testimony overwhelmingly sided with a so-called “clean” Medicaid expansion. Over and over again, individuals and healthcare-related groups told the House Health and Welfare Committee they don’t want mandatory work requirements or other restrictions.

Brian Whitlock, president and CEO of the Idaho Hospital Association and someone who campaigned for Proposition 2, says foregoing any tweaks to the expansion is a “matter of fairness”.

“I think it’s a matter of decency and from a part-time legislator’s perspective making $17,358 a year with full healthcare coverage, it should also be a matter of consistency,” Whitlock says.

Brie Katz says she’s in the middle of treatment for breast cancer. She says she wants to work, but she isn’t sure she’d be able to meet the threshold of 20 hours a week.

“Even with my resources and my network, it’s barely been possible for me to string together 15 hours a week of work that’s flexible enough to accommodate my treatment schedule and the unpredictability of my side effects,” Katz says.

People testifying also criticized the added bureaucratic costs to tracking work requirements. That’s estimated to cost the state nearly $1.5 million a year, according to the bill’s fiscal analysis.

Fred Birnbaum, vice president and COO of the Idaho Freedom Foundation, says his group supports the concepts of the bill.

Birnbaum notes that work requirements and other restrictions on the expanded population can help curb ballooning costs. If nothing is implemented, “It’ll threaten the program for everyone,” he says.

The Idaho Freedom Foundation also filed suit last year questioning the program’s constitutionality. The Idaho Supreme Court rejected their argument last month.

Other portions of the bill would require state lawmakers to review Medicaid expansion no later than January 2023, give some enrollees the option to stay on a private coverage plan through Idaho’s insurance exchange and automatically shut down the program if the federal government changes the cost-sharing ratio.

One popular part of the bill – and one that was brought up several times during the hearing – was getting federal permission to cover those with significant mental illnesses who need to be hospitalized.

Idaho lawmakers still need to fund Medicaid expansion before recessing for the year. Gov. Brad Little (R) has said he won't let legislators go home without doing so.

Vander Woude says revisions to the bill are likely to come early next week.

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