Health coverage gap dominates final days of Idaho legislative session

BOISE – Last-minute attempts to move forward with a plan to provide health coverage for the 78,000 Idahoans who fall into a coverage gap delayed the end of Idaho’s legislative session on Thursday, as the Senate passed a coverage bill and adjourned, but the House had yet to act.

“Senators, we’ve been kicking this issue around for three sessions now and it’s time for a reality check,” declared Sen. Jim Guthrie, R-McCammon. “We need to either fish or cut bait.”

On Thursday morning, a Senate panel rejected a House bill to spend the next year studying the state’s health care coverage gap and instead amended another House bill to launch the process of seeking a federal waiver to cover currently uncovered Idahoans.

The Senate then passed the amended House bill on a 27-8 vote, with four North Idaho senators dissenting: Sens. Bob Nonini, R-Coeur d’Alene; Sheryl Nuxoll, R-Cottonwood; Mary Souza, R-Coeur d’Alene; and Steve Vick, R-Dalton Gardens.

Because Idaho has declined to accept federal Medicaid expansion funds, 78,000 Idahoans currently make too little to qualify for subsidized health insurance through the state insurance exchange, and also don’t qualify for the state’s limited Medicaid program, leaving them with no coverage options. The amended bill would cover that group – those who make less than 100 percent of the federal poverty level – under a new managed-care program Idaho would develop, using the federal funds as a block grant.

Lawmakers still would have to give approval next year before anyone could be enrolled.

In the Senate debate, Guthrie said, “I believe we have the courage to pass this legislation and apply for a waiver. I despise Obamacare as much as many of you, but at least a waiver allows us to craft an Idaho solution for a very real problem. … Another year is a long time to wait to do the right thing.”

Sen. Abby Lee, R-Fruitland, said Idaho’s current medical indigency and catastrophic care program is “an inefficient and expensive way to deal with this.” She said sticking with the status quo “won’t make it go away and it is not fiscally conservative.”

Sen. Todd Lakey, R-Nampa, said, “We know that the Affordable Care Act created this problem with the gap. … We live in the world we live in as a result of the Affodable Care Act, and this is a problem that needs to be addressed. I oppose Medicaid expansion, but I don’t look at this as Medicaid expansion. Medicaid is a defective system of care. But I can live with Medicaid reform, in the world that we live in now. I think this request allows us to explore that opportunity.”

Sen. Marv Hagedorn, R-Meridian, said it’s time to “figure out how to make lemonade out of lemons. This is the best lemonade we can put together right now, to try and get ourselves some type of a waiver that we can then look at next session and choose to implement if we find that appropriate.”

To become law, the amended bill would need the House’s concurrence in the Senate amendments. As the session stretched into the evening, the House adjourned until Friday morning, when it will take that up. The Senate finished its business and adjourned for the session.

At an earlier public hearing on proposed legislation to expand Medicaid, a doctor from eastern Idaho testified that Idaho’s failure to take action on Medicaid expansion over the past three years has resulted in the premature deaths of nearly 1,000 Idahoans.

Outside the Idaho House and Senate chambers on Thursday, two colorful floral funeral wreaths were set up, with a sign in the center saying, “Close the Gap Now, Not One More Death.”