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Idaho will submit all Medicaid expansion waivers by December

UPDATED: Fri., Sept. 27, 2019

By Keith Ridler Associated Press

BOISE – All waivers for restrictions state lawmakers added to voter-approved Medicaid expansion will likely be submitted by December to the U.S. Department of Health and Human Services for possible approval, Idaho officials have said.

The Idaho Department of Health and Welfare, in an update on the process Thursday, said it’s taking public comments on waivers, taking steps to fix problems with a rejected waiver, and negotiating with the federal agency.

Waivers are required when a state wants to deviate from standard Medicaid rules.

The waivers could take months to process, with final decisions occurring after enrollment begins Nov. 1 and coverage starts Jan. 1. But those dates will remain valid.

“Medicaid expansion will happen on Jan. 1, 2020, regardless of the status of the waivers,” said Idaho Department of Health and Welfare spokeswoman Niki Forbing-Orr.

She said if waivers are approved past the deadlines, the agency would work to inform those affected.

Voters authorized Medicaid expansion with an initiative in November that passed with 61% of the vote after years of inaction by the Idaho Legislature.

The expansion provides Medicaid to people earning up to a maximum of 138% of the federal poverty level. That maximum is about $17,000 a year for one person and $35,500 for a family of four.

Of Idaho’s estimated 1.8 million residents, about 275,000 in June were covered by Medicaid and the Children’s Health Insurance Program, according to the U.S. Department of Health and Human Services’ Centers for Medicare & Medicaid Services. Medicaid expansion would add an estimated 90,000 people costing $400 million, with the federal government paying 90%.

Idaho lawmakers earlier this year added restrictions to the voter-approved law, each requiring waivers from the federal government.

There are five waivers in all.

Federal officials in August rejected a waiver request as incomplete that would allow Idaho residents who qualify for the expansion to stay on the state’s health insurance exchange.

“This waiver remains a high priority for Idaho, and Idaho is already taking steps to submit additional information,” the state agency said in the update on its website.

A second similar waiver is on hold because federal officials say it may not be necessary, state officials report.

Idaho officials are currently taking public comments on a third waiver involving a work requirement and a fourth waiver requiring referrals for family planning services such as birth control, abortions or pregnancy care.

A fifth waiver expected to be released for public comment in November would allow Medicaid recipients to receive inpatient treatment for mental health and substance abuse disorders at a freestanding psychiatric hospital. Currently, those services are only available in the psychiatric unit of a full-service hospital.

On a related front, Idaho lawmakers have been discussing how to pay the roughly $40 million it will cost the state for the expansion, but nothing has been finalized.

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