Idaho lawmakers adjourn without addressing health care coverage gap

BOISE – The Idaho House of Representatives shot down a health care bill on a party-line vote Friday, leaving 78,000 people without coverage for another year.

Idaho lawmakers then adjourned despite a last-minute effort Thursday night in the Senate to close the coverage gap affecting those characterized as Idaho’s working poor.

The approach backed by the Senate didn’t favor expanding the traditional Medicaid program, something multiple task forces and study committees convened by Gov. Butch Otter say would provide much-needed care and save the state millions – and something most states have done under the federal Affordable Care Act.

Instead, the bill amended by the Senate late Thursday directed the state to seek a waiver from the federal government to tap Medicaid expansion funds to pay for a new, Idaho-developed managed care program. Lawmakers still would have had to approve the waiver next year before anyone could be enrolled.

But the House shot down the bill.

“We did not have the votes – I counted – even with the Democrats,” said Rep. Luke Malek, R-Coeur d’Alene.

Five House Republicans who had pledged on Thursday not to vote for any bills or rules next year until they can vote to cover the gap population joined in the “no” vote.

“When we started the session, there was absolutely no talk that we were going to do anything about the gap, and we took this issue almost all the way to the finish line this year,” Malek said, “and that gives me a lot of hope that we’ll do something soon to solve this problem.”

The gap population are people who make too little to qualify for the subsidized insurance through the state health insurance exchange but too much to qualify for Medicaid.

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.

Idaho uses local property taxes and state general funds for its Catastrophic Care Program, which pays after the fact for those who run up big medical bills they can’t cover. Medicaid expansion would eliminate that program.

House Speaker Scott Bedke, R-Oakley, announced after the adjournment that he’ll appoint a bipartisan working group to start meeting in May to develop a solution for the gap population.

“There is a clear understanding that the gap population, the medical services they receive are inadequate,” Bedke said. “It’s an inefficient use of taxpayer dollars, and there’s bad outcomes.”

Rep. Vito Barbieri, R-Dalton Gardens, said Idaho is “moving in the right direction,” and said in his opinion, expanding Medicaid isn’t the answer.

Sen. Todd Lakey, R-Nampa, said the federal Affordable Care Act “created this problem with the gap,” but said it’s a problem that needs to be addressed.

To get a bill to the House in the waning days of the 2016 session, the Senate tacked the waiver proposal onto a House-passed bill that would have granted $5 million a year to community health centers to provide services to the gap population. When the House rejected the amendments, the grant program died, too.

Sen. Dan Schmidt, a physician who’s pushed hard all year to get lawmakers to consider the coverage gap, said he was happy the Legislature is talking about the issue. “It’s been put off so long,” the Democrat from Moscow said. “We’re not serving our state by doing that.”

He added, “I think the majority party got very uncomfortable with the stance they’ve been taking, and in my opinion, that’s good.”