BOISE – The Idaho Legislature’s work to close Idaho’s health coverage gap isn’t over, even though President-elect Donald Trump has vowed to repeal Obamacare.
“I don’t believe that is dead,” said House Speaker Scott Bedke, R-Oakley. “I don’t think the problem has gone away.”
A legislative panel is examining alternatives for the 78,000 Idahoans who make too little to qualify for the state’s limited Medicaid program, but not enough to qualify for subsidized health coverage through the state’s insurance exchange. Those Idahoans make less than 100 percent of the federal poverty level.
Under the Affordable Care Act, Medicaid was supposed to expand and absorb people in the coverage gap, which largely consists of the working poor. But after the U.S. Supreme Court ruled that that move was optional for states, Idaho has continued to debate it, and hasn’t decided whether to expand its Medicaid program.
Bedke earlier this week told the Twin Falls Times-News that Medicaid expansion is no longer on the table in Idaho, saying, “No sense in working on the branches of a problem if the root is going to be pulled up.”
But Bedke said the working group’s charge remains. “I think they have identified some state money that could be spent more effectively and more efficiently,” he said.
Senate President Pro-Tem Brent Hill, R-Rexburg, said Idaho’s existing medical indigency and catastrophic care program, which pays medical bills for people facing catastrophic expenses who can’t pay up, and then puts liens on their homes and everything they own in usually unsuccessful attempts to get reimbursement, is “already costing the citizens of Idaho tens of millions of dollars.” He said, “Let’s find a better way to use that.”
Rep. Luke Malek, R-Coeur d’Alene, pointed to the health care reform priorities outlined on President-elect Trump’s transition website, greatagain.gov.
“They say they want to work toward a patient-centered health care system that promotes choice, quality and affordability, which is exactly what that group has been talking about,” Malek said. “And they want to maximize states’ flexibility in administering Medicaid, which is also exactly what that group has been talking about.
“We have a good model in the state of Idaho to manage cost and make sure that everyone has coverage and access, and do it from an Idaho-based level,” Malek said. “So I think it actually provides a lot of opportunity.”
House Minority Leader John Rusche, D-Lewiston, who lost his re-election bid this week, said he already thought Medicaid expansion was unlikely in Idaho. “Even prior to the election, I thought it would be a very difficult thing to get the House Republican leadership, particularly … to saliently move forward on that issue,” he said.
Sen. Dan Schmidt, D-Moscow, who like Rusche is a physician and like Rusche also lost his re-election bid, said, “The majority party took a very firm stance. I just want to compliment the governor for the state-based exchange. I think that was a great idea, and it worked real well.”
At Otter’s urging, lawmakers approved a state insurance exchange for Idaho, which has helped nearly 100,000 Idahoans obtain insurance, most with federal tax subsidies. But after approving the exchange, lawmakers stopped short of Medicaid expansion, saying they didn’t want to cooperate with Obamacare.
Schmidt, who with Rusche was among the leaders of the push to expand Medicaid in Idaho, said, “Trying to make the market forces apply to health care is a monumental task, and I applaud the governor for doing that with the state exchange.”
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