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Governor-elect commits to Medicaid expansion

Idaho Gov.-elect Brad Little answers a reporter's question at the State Capitol building Thursday, Jan. 3, 2019 in Boise, Idaho. (Otto Kitsinger / Associated Press)
By Keith Ridler Associated Press

BOISE – Gov.-elect Brad Little said Thursday he’s committed to implementing a voter-approved expansion of Medicaid coverage but has concerns on the specifics of how it’s done.

“We will implement it in an Idaho manner,” Little said at the Associated Press Legislative Preview a day before he’s sworn in as Idaho’s 33rd governor. “We don’t want to have an incentive for people not to work.”

Little didn’t specify whether he meant work or other requirements for the estimated 60,000 low-income adults across the state that would receive coverage. He said he’s talking with governors in other states where voters backed Medicaid expansion.

Little touched on an array of topics, first noting that Gov. C.L. “Butch” Otter and Otter’s staff have been helping Little transition from lieutenant governor. Little said he has 100 percent of his staff filled and about 90 percent of the rest of the state government will be filled by the end of the week.

“We’re on schedule,” he said.

Republican House Speaker Scott Bedke of Oakley, Democratic House Minority Leader Mat Erpelding of Boise, Republican Senate President Pro-Tem Brent Hill of Rexburg and Democratic Senate Minority Leader Michelle Stennett of Ketchum also took part in the AP preview. The Idaho Legislature begins work on Monday.

In general, the lawmakers agreed that Medicaid expansion would be a top priority, though there appeared to be differences between the Republicans and Democrats on what they hoped to see emerge. Medicaid expansion is already the law following the voter-approved initiative Proposition 2, but how it’s funded and what requirements, if any, are made for people to receive Medicaid have yet to be hashed out. Thousands of Idaho residents have been living “in the gap,” earning too much to qualify for Medicaid health insurance but not enough to get subsidized health care coverage under the state insurance exchange.

Bedke doubted lawmakers would leave the law untouched, with a work or training requirement a possibility.

“Being on a track that puts you to a better place is probably going to be the responsible thing to do with taxpayer dollars,” he said.

Stennett and Erpelding, noting the preference of the majority of Idaho voters, wanted funding without work or other requirements.

“I’m of the opinion that if two out of three Idahoans decided they wanted a clean Medicaid expansion that’s what we should be entertaining because that’s what Proposition 2 said,” Stennett said.

Officials say Idaho would receive $400 million from the federal government to pay for the expansion. Idaho would be responsible for 10 percent of that. Lawmakers on Thursday noted that potentially more people – more than 100,000 perhaps – could sign up for Medicaid, which would increase the costs.

The libertarian think-tank Idaho Freedom Foundation has sued the state over the voter initiative and the Idaho Supreme Court is expected to hear arguments later this month.

A conservative federal judge in Texas declared the Affordable Care Act unconstitutional, but the law remains in place while the appeals continue.

Despite those developments, the Idaho lawmakers generally said they planned to move ahead and work on Medicaid expansion.

“There’s a lot of uncertainty,” Hill said. “But in my opinion we have to go forward in good faith.”

Erpelding said lawmakers should in January have the Medicaid expansion appropriations ready to go.

Other big issues lawmakers expect to grapple with include education funding, infrastructure and paying for prisons.

“Idaho is definitely in a good spot,” said Bedke. “Our economy is strong, we’re growing.”

But lawmakers expressed concern about taxes coming into the state and uncertainty about state revenue.

Idaho lawmakers passed what was billed as one of the biggest tax cuts in state history in March. The bill had two prongs: One aligning Idaho’s tax code to match the federal tax overhaul and the other to offset the roughly $100 million more in federal taxes that Idahoans are expected to pay because of the federal changes.

But the Idaho Division of Financial Management has said monthly individual tax revenues have been lower than expected, which means people likely aren’t withholding as much as they need to under the new tax rules. That could result in taxes coming in after the Legislature finishes its work, which is anticipated sometime in late March or possibly early April.