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Thursday, November 21, 2019  Spokane, Washington  Est. May 19, 1883

Eye On Boise

Legislative leaders optimistic new panel can help state close coverage gap

The Idaho state Capitol in Boise (Betsy Z. Russell / The Spokesman-Review)
The Idaho state Capitol in Boise (Betsy Z. Russell / The Spokesman-Review)

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By Betsy Z. Russell

BOISE – Idaho’s top House and Senate leaders expressed optimism Friday that a new legislative panel can help state lawmakers resolve their differences and find a way to cover the 78,000 Idahoans who fall into a health coverage gap.

House Speaker Scott Bedke and Senate President Pro-Tem Brent Hill named 10 lawmakers to a bipartisan “working group” charged with examining alternatives for covering those Idahoans, who make too much to qualify for Idaho’s very limited Medicaid program, but not enough to qualify for subsidized health insurance through the state insurance exchange.

Expanding Medicaid to include that gap group was originally part of the federal Affordable Care Act, but the U.S. Supreme Court ruled that’s optional for states; Idaho hasn’t taken action, so its Medicaid program still covers essentially only poor children and the disabled. That’s left the state in the paradoxical position of helping middle-income Idahoans afford health insurance through the new exchange, but turning away the working poor because they don’t make enough.

During this year’s legislative session, House Health and Welfare Chairman Fred Wood, R-Burley, said his committee had reached consensus that “what is currently happening is just unfair and wrong.” During a Senate committee hearing, the director of critical care at a major hospital in eastern Idaho told lawmakers the state’s failure to expand Medicaid has resulted in more than 1,000 premature deaths of Idahoans in the past three years, for lack of treatment.

Gov. Butch Otter has convened two study groups to address the problem; both recommended accepting millions in federal Medicaid expansion funds, either to expand Idaho’s Medicaid program, or, through waivers, to set up a new coverage system for that group.

But the Legislature never acted on the proposals. This year, Otter instead proposed a $30 million-a-year investment into primary care for the gap population, but the proposal was decried for providing doctor visits, but not the pricey follow-up or specialist care required for patients who are seriously ill.

Late in the session, the Senate voted overwhelmingly, with just eight Republican members dissenting, to direct the state Department of Health and Welfare to immediately start work on a waiver application, to allow Idaho to tap federal Medicaid expansion funds for an Idaho-designed program to provide managed care to the state’s gap population, specifying that it would cover those who make less than 100 percent of the federal poverty level. That’s the point at which Idahoans are turned away from the state insurance exchange.

The House killed the bill on the final day of the legislative session, on a straight party-line vote with all majority Republicans voting no. Bedke pledge then to push for the working group.

The House speaker said Friday that he thinks the new House-Senate panel can “reconcile the positions between the two bodies, and come up with a path forward that the Legislature can stand behind.”

Hill said he wants the panel to “give us all the alternatives that are out there – what’s most successful? What’s working?”

“I’m very optimistic, I really am,” Hill said. “I don’t think we’re as far apart as people think we are.”

The new panel’s co-chairs will decide when it will start meeting; they are Sen. Marv Hagedorn, R-Meridian; and Rep. Tom Loertscher, R-Iona. No one from North Idaho was named to the panel, which includes five senators and five representatives, two of them minority Democrats.

Bedke and Hill announced the new panel at a meeting of the Legislative Council on Friday. That’s the joint committee that oversees legislative matters in between sessions. The two also announced a new working group on faith healing and children at risk; and another one on invasive species.

Susie Pouliot, CEO of the Idaho Medical Association, was among a coalition of health care providers and advocates who welcomed the new group’s formation. “We are eager to find a path forward for the tens of thousands of Idahoans living without affordable medical care,” Pouliot said in a statement from the “Close the Gap Idaho” coalition. “It is vitally important that the work group develop a complete solution that brings our federal tax dollars back to Idaho, replaces our costly and inefficient indigent system and ensures that all Idahoans have full health coverage.”

Eight formal legislative interim committees, all authorized by lawmakers during the 2016 session, also were approved by the council on Friday. They include new panels to re-examine Idaho’s school funding formula; study the state foster care system; and examine state employee benefits and state agencies’ use of hearing officers. Four existing committees were continued, including one examining Idaho’s state procurement laws.

Rep. Luke Malek, R-Coeur d’Alene, was named co-chairman of the Criminal Justice Oversight Committee, replacing House Judiciary Chairman Rich Wills, R-Glenns Ferry, who was defeated in the May GOP primary election.

Sen. Steve Vick, R-Dalton Gardens, was named co-chairman of the panel that will examine agencies’ use of hearing officers.

Betsy Z. Russell
Betsy Z. Russell joined The Spokesman-Review in 1991. She currently is a reporter in the Boise Bureau covering Idaho state government and politics, and other news from Idaho's state capital.

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