Issues aired at Idaho Medicaid hearing

A plan to give low-income Idahoans a choice between free government health care and subsidized private health insurance drew a lukewarm response at best during a public hearing in Lewiston on Thursday.

About 20 people attended the hearing, which was hosted by the Idaho Department of Insurance.

The purpose was to take comment on a Medicaid expansion waiver that would give people who earn 100 percent to 138 percent of the federal poverty level the option to buy subsidized insurance through the state exchange, rather than automatically shift to the Medicaid program.

The waiver was one of several conditions the Idaho Legislature added to the voter-approved Medicaid expansion plan earlier this year.

Of the 13 people who spoke during Thursday’s hearing, seven flatly opposed the waiver, saying it was an attempt to confuse people and discourage them from signing up for Medicaid.

Michael Riley of Potlatch, for example, noted that many Idahoans worked hard to pass the Medicaid expansion initiative, believing that their friends and neighbors should have access to health care.

“Then the Legislature got involved,” he said. This private insurance waiver “is the Legislature’s attempt to stand against the people. If they’re for it, I’m against it.”

Rebecca Schroeder, executive director of Reclaim Idaho, the grassroots organization that led the charge for Medicaid expansion, said the 100-138 waiver “is a bait-and-switch that tries to steer Idahoans to more expensive private (health insurance) plans.”

“Medicaid provides more reliable coverage, while the private exchange plans require copays and deductibles,” she said. “This waiver is nothing more than a mechanism to confuse people.”

A handful of speakers applauded the idea of offering people a choice between private insurance and Medicaid. However, they all said the state needs to do a thorough job educating people about the various options, rather than simply leave them to fend for themselves.

“Medicaid offers mental health coverage and other benefits that might not be available under private insurance plans,” said Susan Ripley, representing the Idaho League of Women Voters. “A mechanism has to be put in place to inform people about the pros and cons of both options, before they have to choose.”

From a taxpayer perspective, Ripley also noted that Medicaid coverage costs about $3,800 per person, compared to $7,000 to $8,000 for subsidized private insurance through the state exchange.

Eric Peterson, who serves on the Nez Perce County Republican Central Committee, supported the waiver application. However, he thought anyone who chooses to pay for private insurance rather than enroll in Medicaid was making a “dumb” move, financially and pragmatically.

Like other speakers, Peterson noted private insurance involves out-of-pocket copays and potentially significant deductibles. And if insurance doesn’t cover all their bills, that expense falls back on the state and county indigent fund.

“I’m going to write letters to the editor saying if you do this, you’re putting yourselves and the state at risk,” he said.