Medicaid bills get mixed response
BOISE – Long-sought legislation to let disabled Idahoans work without losing needed Medicaid benefits cleared a House committee unanimously on Tuesday.
So-called “Medicaid buy-in” lets those workers pay premiums on a sliding scale as their incomes increase rather than losing their coverage. Under current laws, many disabled Idahoans have been discouraged from working or increasing hours or earnings for fear of losing the very medical services that allow them to work.
A group of people in wheelchairs who sat through the committee hearing couldn’t contain a few shouts of “Yay!” as they left the hearing room. Bobby Ball, head of a small nonprofit, said, “I haven’t taken a raise in about five years. … So I’m going to take the raise when this goes through, and I’m going to buy something real big for my grandbabies.”
Kelly Buckland, director of the State Independent Living Council, has been pushing for the program for the past 10 years. Last year, Medicaid buy-in passed the Senate but never got a hearing in the House Health and Welfare Committee. Tuesday’s approval came from that same panel.
“We’ve got a ways to go, but that’s obviously a great sign,” Buckland said.
Rep. Kathie Garrett, R-Boise, who co-sponsored the legislation with Buckland and Sens. Shawn Keough, R-Sandpoint, and Dick Compton, R-Coeur d’Alene, said, “It came out unanimous – they understood that concept that in Idaho we value work, and this is a work opportunity program.”
The bill, HB 664, now moves to the full House.
In the committee hearing, House Speaker Bruce Newcomb offered moving testimony in favor of the bill. He recalled a friend who was paralyzed in a hay bale loading accident – and how much difference it made to him when a tractor was retrofitted so he could once again plow and disk his own fields.
“We have a tendency to just look at the numbers, but overlook the faces behind the numbers,” Newcomb told the committee. The program will cost the state $233,900 next year and $397,200 in fiscal year 2008, he said.
“But you know what, that’s a small price to pay to give people the ability to live independently,” Newcomb said. “In my view … it’s the Christian thing to do.”
The committee was less receptive to two bills designed to kick off Gov. Dirk Kempthorne’s Medicaid reform program, HB 662 and HB 663. HB 662 lays out the overall framework for the reform, dividing the program that provides health coverage for poor and disabled Idahoans into three separate programs for different populations. One would target healthy children and adults, another would be for the disabled, and a third would be for the elderly. Each program would have different goals and offer different services.
Representatives from an array of health-care organizations testified in favor of HB 662, as did a lobbyist for the Idaho Association of Commerce and Industry who said it would be a first step toward reining in fast-rising Medicaid costs.
“The business community has recognized over the last few years that the Medicaid budget is certainly overtaking some of the spending priorities of the state,” said lobbyist Teresa Molitor.
Members of the Idaho Community Action Network, however, testified against the bill, saying they thought it would endanger the “safety net” for the poorest Idahoans and shift new burdens onto county indigent funds. Members said the inclusion of new co-pays, premiums and charges for missed appointments could cause needy recipients to leave Medicaid, then turn to emergency rooms or indigent funds for care.
Kathryn McNary, a disabled mother of two from Caldwell and an ICAN board member, said, “I’m worried that this Medicaid proposal is a gamble with my family’s health care.”
A motion to approve HB 662 and send it to the full House failed on a 6-6 vote. Committee members then began discussing possible amendments but decided instead to hold off on decisions on both HB 662 and HB 663 to allow time for more study. Committee Chairwoman Sharon Block, R-Idaho Falls, noted that many people have worked for months on the proposals.