BOISE – Idaho Gov. Butch Otter said Monday he was “a little disappointed” state lawmakers took no action to close the state’s health coverage gap for the working poor, but he said he won’t call a special session or issue an executive order.
Instead, he’ll work with the Legislature’s new task force between now and next year.
“A year ago, we weren’t even talking about this sort of thing,” Otter said at a Capitol news conference called to give his reaction to the just-concluded legislative session. Now, there are two ideas that have to be melded into an “Idaho solution” to the health coverage gap problem, he said.
In the final days of the session last week, the Senate overwhelmingly approved legislation directing the state to apply for a waiver from federal authorities to tap Medicaid expansion funds as a block grant. That money would be used to provide a new managed-care plan to the 78,000 Idahoans who make too little to qualify for subsidized insurance through Idaho’s health insurance exchange, but too much to qualify for Medicaid. A day later, the House rejected the bill on a party-line vote, with all Republicans opposing it.
Instead, House Speaker Scott Bedke announced he’ll appoint a group of lawmakers to work to find a solution for next year’s Legislature to consider.
Otter, who over the last three years appointed two separate task forces that studied the issue at length before recommending accepting the federal funds, said he knows the coverage gap is a problem. “Those who would suggest that the Republicans in the Legislature don’t care about those 78,000 are dead wrong – we do care. We just are trying to get a solution and not make false promises,” he said.
The governor, in response to questions from reporters, said he may have erred by only appointing a few state lawmakers to his two Medicaid Redesign Working Groups.
“Mostly they were not made up of those people that could vote on what they had generated,” Otter said, “and that’s a pretty important aspect.”
Otter said he’s hoping Bedke’s working group will call on the experts who contributed to his previous efforts to find a solution.
“I counted more on the experts than I counted votes,” Otter said, “because I thought, you know, once we can see a clear path, we’ll just do the right thing. I think it’s time that we included those votes on those working committees.”
Asked about testimony provided to the Legislature this year by a critical care doctor in Idaho Falls who estimated that 1,000 Idahoans have died prematurely in the past three years for lack of health coverage and predicted more than 300 more deaths in the next year if Idaho doesn’t act, Otter said he wasn’t convinced.
“The idea that people are dying because they don’t have health care in Idaho, I don’t totally agree with that,” Otter said. “I think the doctor was off-base. I see plenty of people that die every day in hospitals and they have insurance, and they’re in the hospital, but they still die. If it were easy, I guess we would have accomplished it a long time ago.”
The doctor, Kenneth Krell of the Eastern Idaho Regional Medical Center, told legislators of a patient – Jenny Steinke of Idaho Falls – who died from complications from asthma. She lacked insurance to cover what would have been relatively simple treatment earlier, Krell said.
Bedke said the Idaho House has heard the “hyperbole and horror stories.” What’s needed now, and what the people of Idaho have, is “a firm commitment from the House of Representatives that we want to do something on this issue,” he said.
He added, “This is going to take four to tango here,” including the state House and Senate, the governor’s office and the federal Center for Medicare and Medicaid Services, which would need to approve a waiver to use federal funds.
The federal Affordable Care Act originally envisioned all states expanding Medicaid to serve their lowest-income residents, while those with slightly higher incomes could use their state insurance exchanges.
A U.S. Supreme Court decision made Medicaid expansion optional for states; 31 states, including Washington, have exercised the option, but Idaho hasn’t.
Close the Gap Idaho, a coalition of medical, civic and advocacy groups that has been pressing for action on the issue, posted on its website, “Now we have to wait at least another year. We are grateful for the courage and compassion of many legislators, and for the many thousands of Idahoans who contacted their legislators to show their support for Idahoans in the gap. But we are heartbroken for the 78,000 Idahoans who still do not have access to health care.”
Lauren Necochea, director of Idaho Voices for Children, a coalition member, saidmost of the Idahoans in the gap are working at least one job and have children at home.
“It is urgent that Idaho closes the coverage gap,” she said. “The lives of Idahoans and the economic stability of our families are under threat until we address this critical issue.”
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