The Idaho House and Senate have reached consensus on adding mandatory work requirements to a popular Medicaid expansion initiative. State senators signed off on the bill 19-16 Friday afternoon.
They chose to preserve the House amendments, after rejecting a recommendation from a committee made earlier in the day to scratch them.
The vote comes just a day after the House added these provisions, which would kick people off of Medicaid if they failed to work enough.
A person could be dropped from their coverage for two months if they don’t work, volunteer or study for at least 20 hours per week under the proposal. They could reapply for Medicaid if they can prove they meet the requirements.
The proposal would need approval from the federal Centers for Medicare and Medicaid Services to go into effect. Similar work requirements in Arkansas and Kentucky were struck down by a federal judge last month because they would keep “a substantial number of people” from getting health coverage.
But backers of the bill say this plan is different from programs in those two states. Regardless, they say they want something in place before the legislature adjourns.
“We’ll probably be discussing this every year for the next several years until we get it to a place that we’re comfortable with,” said Sen. Mary Souza (R-Coeur d’Alene). “This is a good bill and a good place to start.”
Senate Majority Leader Chuck Winder (R-Boise) agreed. “I think it isn’t exactly what everyone would want, but I think it has the opportunity to help immediately, in the near future, 60,000-70,000 Idahoans that don’t have coverage,” Winder said.
In all, the bill is expected to cost the state $865,000, with about $500,000 of that as ongoing, annual expenses.
Over the past few days, several lawmakers in both chambers have decried the speed at which the bill was ushered through the lawmaking process: it was first significantly amended from its original form by the Senate Monday, tweaked by the House again Thursday and is now on its way to Gov. Brad Little’s (R) desk.
Sen. Janie Ward-Engelking (D-Boise) was among all seven Democrats and nine Republicans who voted against the bill. She says mandatory work requirements were not what nearly 61% of people in Idaho voted for when they passed Proposition 2 last November.
“This bill may actually do harm to families, to people who are kicked off Medicaid and left with no insurance,” Ward-Engelking said.
In fact, the original version of the bill would’ve offered a voluntary work training program for those enrolling in Medicaid before it was heavily amended earlier this week – something that received bi-partisan support when it was introduced.
Along with mandatory work requirements, the proposal would also ask the federal government for a waiver to enroll those earning between 100-138% of the federal poverty level in a subsidized plan from Idaho’s health insurance exchange, though that person could choose to move to Medicaid instead.
Anyone seeking birth control or other family planning care from clinics or specialists – like an OB-GYN – would first need a referral from their primary doctor as well, if the waiver is approved.
Governor Little hasn’t given much indication whether he’d support such a bill. In the past, he’s said Idaho’s social safety net needs some “spring” in it to help people break the cycle of poverty.
He’ll have the opportunity to weigh in on the issue next week.
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