Medicaid buy-in advances
BOISE – A Senate committee almost unanimously approved a bill Thursday that would make it easier for disabled people to work and still get expensive services under Medicaid, but cautioned such a program wouldn’t be funded this year by budget writers.
“It sounds like if we pass this it will be dead upon arrival,” said Sen. Dick Compton, R-Coeur d’Alene, chairman of the Health and Welfare Committee.
SB 1143 would implement a Medicaid buy-in program, where disabled, working people could still get the federal program’s benefits – such as personal assistance or aid for costly equipment – by paying premiums on a sliding scale when their incomes grow. Currently, they risk being shut out of the program if they make too much money or work too many hours.
The Department of Health and Welfare estimates the program would cost the state’s taxpayers an extra $430,000 in the 2006 fiscal year. Members of the panel said they’ve been told the Joint Finance-Appropriations Committee won’t approve the added costs.
“Will it be funded?” Sen. Denton Darrington, R-Declo asked rhetorically. “The answer is an absolute no. The co-chairman of JFAC told me it will not be funded. But there’s no question there’s a need for it.”
In a hearing that was extended from Monday, Darrington was the only lawmaker who voted against sending the bill to the full Senate.
“We’ve really got burned from the rule of unintended consequences with supplemental programs for Medicaid in the past,” Darrington said. “I’m afraid that might happen again this time.”
The committee, which took testimony earlier in the week, spent almost an hour Thursday discussing how the state could fund a program all agreed was desperately needed. Officials at the Department of Health and Welfare said there are other alternatives, including a limited buy-in program that doesn’t affect the budget, but the legislators decided in the end to back the bill.
“I was one of the JFAC members that voted to put in a buy-in program” last year, said Sen. Shawn Keough, R-Sandpoint, a vice chairwoman of the budget panel. “I am concerned about the money…. Philosophically, we need to go down this path.”
A buy-in program has been discussed in the Legislature since 1996, when then-Gov. Phil Batt’s Medicaid reform advisory council recommended it. Federal legislation gave states that option three years later, and Idaho even got a federal grant to design such a system, but never started one up.
The same measure, which 28 states have enacted in some form, failed last year in JFAC by one vote.
Kelly Buckland, the author of the bill and director of the State Independent Living Council, said it will help disabled Idahoans escape poverty and become less dependent on the state.