Here's my full story from spokesman.com on today's final chapter in this year's health care fight, which ended with the House killing a bill on a party-line vote and adjourning for the year:
BOISE – The Idaho House shot down a health care bill on a party-line vote Friday and adjourned, leaving the state’s health care coverage gap unaddressed for another year.
“We did not have the votes – I counted,” said Rep. Luke Malek, R-Coeur d’Alene, “even with the Democrats.” Malek joined with all other House Republicans to kill bill the Senate had amended and passed Thursday in a last-minute attempt to move forward with a plan to provide health coverage for the 78,000 Idahoans who make too little to qualify for the subsidized insurance through the state health insurance exchange, but also don’t qualify for Medicaid.
Even 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 on concurrence with the Senate amendments.
Malek said, “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, and that gives me a lot of hope that we’ll do something soon to solve this problem.”
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.”
“You’ll see me pursuing that,” Bedke said. “You’ll see me reaching out to the Senate to do that.”
He said, “There is a clear understanding that the gap population, the medical services they receive are inadequate, it’s an inefficient use of taxpayer dollars and there’s bad outcomes.”
Rep. Vito Barbieri, R-Dalton Gardens, welcomed the outcome. “We know that we’ve got issues here that have got to be addressed,” he said. “I think we’re moving in that direction.” He added, “I just think that this whole idea that Medicaid’s the answer – it isn’t the answer. I just don’t agree with that.”
After the U.S. Supreme Court ruled that expanding Medicaid to cover the working poor under the federal Affordable Care Act was optional for states, rather than mandatory, Idaho become one of just 19 states that hasn’t done so, though multiple task forces and study committees convened by Gov. Butch Otter have concluded the move would provide care and save the state millions.
Idaho currently uses local property taxes and state general funds for its Catastrophic Care Program, which pays the catastrophic medical bills, after the fact, for those who run up big bills and can’t pay. Medicaid expansion would eliminate that program.
The approach backed by the Senate didn’t favor expanding the traditional Medicaid program. Instead, it directed the state to seek a waiver from the federal government to tap Medicaid expansion funds as a block grant to pay for a new, Idaho-developed managed care program to cover those who make 100 percent or less of the federal poverty level. Lawmakers still would have had to approve the waiver next year before anyone could be enrolled.
All other states that have expanded Medicaid have covered those making up to 138 percent of the poverty line. Idaho lawmakers have been looking this year at holding that line at 100 percent, as those who make more than that can qualify for insurance through the state exchange.
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 Affordable 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.”
The Senate passed the amended bill, tacking the launch of negotiations on a waiver onto a House-passed bill that would have granted $5 million a year for two years to community health centers to provide additional 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, “This was a win-win for me. I was very happy we got this conversation out there, folks recognizing the need to address this issue. It’s been put off so long. 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.”
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 during the final two days of this year’s session, two colorful floral funeral wreaths were set up, with a sign in the center saying, “Close the Gap Now, Not One More Death.”
The Senate vote on the amended plan was 27-8, with just eight Republicans dissenting, including four from North Idaho: Sens. Bob Nonini, R-Coeur d’Alene; Sheryl Nuxoll, R-Cottonwood; Mary Souza, R-Coeur d’Alene; and Steve Vick, R-Dalton Gardens. Senators adjourned for the year on Thursday night at 9, leaving the House to consider the amended bill on Friday morning.
After killing it, and passing an urban renewal reform bill they’d endorsed earlier, the House adjourned around noon. The urban renewal bill, which emerged in part from the work of an interim legislative committee, allows the option of elections for local urban renewal boards; requires a 60 percent vote for urban renewal funds to be used for public buildings like city halls and libraries; and requires all urban renewal plans to be posted annually. It also specifies when modifications to plans should trigger a re-set of property values used for tax-increment financing; the bill, HB 606a, goes to Gov. Butch Otter.