Medicaid reform clears House panel

BOISE – A bill laying the framework for Gov. Dirk Kempthorne’s Medicaid reform plan was approved by a state House committee Wednesday.

The bill, sponsored by Rep. Sharon Block, R-Twin Falls, divides the state’s Medicaid recipients into three categories – low-income children and adults, the disabled and the elderly – in a bid to more narrowly tailor the benefits offered to each group and to slow the fastest-growing portion of the state’s budget.

The proposal passed on an 8-4 vote after two days of hearings packed the Health and Welfare Committee meeting room in the Idaho Statehouse.

“Previously, all the participants were in the same group, and the benefits couldn’t be limited for some without doing so for all,” Block said when the committee first considered the bill last week.

“Some need the services, some don’t, so this legislation is moving away from the federal philosophy that one size fits all.”

The goal is to rein in the increasing costs of Medicaid.

In 1996, the state-federal health plan accounted for about 8 percent of the state budget. By 2005, it had grown to more than 15 percent of the state budget, according to the Legislative Services Office.

Roughly 11 percent of Idaho residents were enrolled in Medicaid in 2003, compared to Utah, where about 8 percent of residents were enrolled, and Montana, with nearly 9 percent enrolled.

Last year, Idaho’s Medicaid recipients had more than $1 billion in medical expenses, though much of those costs were covered by federal dollars.

Rep. Bill Sali, R-Kuna, tried to torpedo the bill, saying it was unnecessary because the director of the state Department of Health and Welfare already has the ability to make the proposed changes.

But Rep. Margaret Henbest, D-Boise, said lawmakers and agency officials had agreed the best way to reform the state’s Medicaid program was through state law.

Kempthorne’s plan would also require copays and other cost-sharing measures for many Medicaid recipients, prompting groups such as the Idaho Community Action Network to speak out against the proposal.

Some families would have to pay monthly premiums between $10 and $45 a month under the plan.

But Catherine McNary, a Caldwell resident and member of ICAN, said she would not be able to pay a premium to keep Medicaid coverage for herself and her two children.

“It seems to me that low-income children are the ones that get cut. Benefits will get reduced, access decreased, and with new premiums many low-income children will stand to lose their health coverage,” McNary said.

Other groups have spoken in favor of the proposal, however, including the Idaho Primary Care Association, the Idaho State Independent Living Council, and the Council on Developmental Disabilities.