Idaho House kills Medicaid gap bill

The House State Affairs Committee crippled Gov. Butch Otter’s proposed alternative to Medicaid expansion Monday by voting to kill a bill that would have provided its funding mechanism.

“I don’t think there was much controversy,” said Rep. Vito Barbieri, R-Dalton Gardens, after joining seven others who voted to kill the bill. “We just need to talk about this a little more.”

The bill would have provided some funding for basic health services to 78,000 Idahoans who make too much to qualify for Medicaid but also don't qualify for health insurance subsidies.

The House State Affairs Committee voted 8-6 to reject a proposal that would partially fund the estimated $30 million plan — dubbed the Idaho Primary Care Access Program.

Two Democratic members voted alongside six other Republican members against the measure. A separate House panel had introduced legislation last week that would create the program's structure, but it did not include a funding mechanism.

House Health and Welfare Chairman Fred Wood, R-Burley, said the rejected bill would have funneled $19 million from the state's Millennium Fund, which comes from a nationwide tobacco settlement. It was still unknown where the remainder of the bill's funding would have come from.

Barbieri said that fact alone was enough to convince him to kill the bill.

“I just want to know how we are going to fund this,” Barbieri said, adding the tobacco settlement money is supposed to be used for tobacco cessation programs. “This bill is only partially funded and we don’t know where the rest of the money is coming from.”

Barbieri said there wasn’t just confusion about the funding source, but also couldn't say how many people the fund would cover.

“Nobody seems to know for sure,” he said. “Is it 76,000, 40,000 or 20,000? I have heard all three. How many people are in this gap?”

Barbieri said he was also concerned about the program becoming permanent.

Rep. Don Cheatham, R-Post Falls, joined five Republicans in voting for the bill.

“I guess there wasn’t enough of us,” Cheatham said after the committee meeting. “I voted for it because I felt it was the best option available at this time.”

Cheatham said Otter’s PCAP proposal would have provided primary medical, dental and behavioral health benefits to the working poor, who otherwise wouldn’t have access to anything but an emergency room.

Cheatham said state and county taxpayers usually end up footing the bill for those emergency room visits, and he felt the PCAP program would have saved money in the state’s catastrophic care funds.

“It also had a five-year sunset clause to give us enough time to evaluate the program and make tweaks if necessary,” Cheatham said, adding he also liked the fact that it is an Idaho plan with Idaho oversight. “There are no federal strings attached to the program. It is completely state-funded.”

Cheatham said legislators have been trying to deal with the health care gap population for the entire time he has been an elected representative, and he feels it is time to get something done about it.

“I just want to get in there and get our hands dirty. We need to get something done about this,” Cheatham said. “There are a lot of people who are out there working but they just cannot afford insurance. You have to be sympathetic to people who are out there trying.”

Rep. Kathy Sims, R-Coeur d’Alene, also voted against the PCAP proposal.

“At the end of all this, we are still $10 million in debt,” Sims said, referring to the fact that the proposal has only been partially funded at this point. “I cannot be Washington, D.C., and engage in deficit spending.”

Sims said there may be another attempt to fund the program and she is willing to listen to it, but she just wasn’t willing to vote for a project without knowing where the funding was coming from.

“They might be able to pull something together, but I don’t know what their Plan B is,” she said, adding she is planning to attend a town hall meeting on Feb. 27. “If anyone has any ideas about this, I am willing to listen.”

The Associated Press contributed to this story.