Medicaid eligibility expansion efforts fail

Idaho lawmakers have failed to finalize a proposal to expand Medicaid eligibility that would appease the Republican supermajority in the waning days of the legislative session.

Instead, two minor proposals were approved Wednesday by the House to devote more resources to studying the so-called Medicaid gap population.

"There are people who believe we shouldn't do a single thing; well, I disagree with that," said Rep. Fred Wood, R-Burley, chairman of the House Health and Welfare Committee. "And there are people who think we should have been doing a lot more a whole long time ago and I disagree with that too ... But the point is that for the first time we are taking a meaningful step."

An estimated 78,000 Idaho residents are caught in a gap where they don't qualify for health insurance subsidies or Medicaid. Whether the Idaho Legislature would address the gap population became a key question as the legislative session wound to a close.

The first measure would create a legislative working group to study the gap population — even though Gov. Butch Otter has convened two similar groups over the years that both endorsed Medicaid expansion.

Rep. Lynn Luker, R-Boise, countered that since those groups were not legislative committees, they were unable to access information about possible solutions to help the gap population.

Meanwhile, the second proposal would approve $5 million for a grant program to collect demographic and health data — as well as expand services — on Idaho's gap population that use community health clinics.

"If this allows you to sleep at night then I would say you are misinformed," said Rep. Sue Chew, D-Boise.

Otter had pitched allocating $30 million to provide basic medical care services to the gap population, but the measure died after lawmakers remained split on the program's benefits and funding structure.

Lawmakers and health care advocates then turned to expanding Idaho's strict Medicaid eligibility requirements, But the proposal was too much to swallow in an election year for many in the GOP caucus.

Another bill circulated last week which would have given Idaho’s Health and Welfare Director the authority to begin negotiating with the Centers for Medicare and Medicaid Services to customize a Medicaid program for Idaho. That bill never got a hearing, according to Rep. Luke Malek, R-Coeur d’Alene.

Malek helped craft the bill which would have started the 18-month process.

Nevertheless, he said, the bills that passed included some of the language in his bill, and he feels it is a step in the right direction.

“This is a good step forward,” Malek said Wednesday afternoon. “Those who voted for this bill are committed to do something next year.”

A key Senate lawmaker did allow a legislative hearing on a proposed Medicaid expansion bill, but he stopped short of allowing a committee vote on the measure. At the same time, multiple protests and demonstrations have taken place inside the Capitol advocating for Medicaid expansion.

Ultimately, it was Luker who introduced two proposals Wednesday that were quickly approved by the House. Supporters argued the two bills were better than doing nothing before the session concluded.