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Feds to force Idaho to selectively expand Medicaid

Feds to force Idaho to selectively expand Medicaid

Dustin Hurst
December 2, 2015
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December 2, 2015

The federal government wants to force Idaho to re-adopt a Medicaid rule that gives health coverage for up to 12 months to program participants who no longer qualify under income restrictions.

The Idaho Department of Health and Welfare will ask lawmakers to vote on the plan, dubbed transitional Medicaid, in the 2016 legislative session, which starts next month.

The request came due to the Idaho Legislature’s decision not to expand the state’s Medicaid program, an option under Obamacare. When federal lawmakers wrote that law in 2010, they required states to expand Medicaid, thereby making the regulation regarding transitional coverage unnecessary.

Because Idaho and a handful of other states see huge flaws in wholesale Medicaid expansion, the federal government wants these states to re-adopt the transition rule, originally written into a 1988 Social Security reform bill.

Tom Shanahan, spokesman for the Idaho Department of Health and Welfare, explained the reasoning behind the regulation.

“Transitional Medicaid allows individuals to begin working and still have access to health coverage for the remainder of the year to ensure they maintain stability in the workforce,” he told IdahoReporter.com.

Shanahan noted, in a two-person home with a non-disabled adult and a child, the adult could be disqualified from Medicaid coverage if the parent earns more than $345 each month, or just more than $4,000 a year. If the transitional rule is re-adopted, after the department determines the parent is ineligible for Medicaid due to this income ceiling, government health coverage would continue for up to 12 months.

Shanahan said the rule gives struggling families a cushion as they reenter the labor force. “The challenge families face is that if their income goes up when they get a job and we immediately end benefits, it makes their transition to self-reliance less successful because most face immediate out of pocket expenses while they are trying to get financially stable.”

The child in that home is, and would remain, eligible for Medicaid coverage until the parent earns more than $2,400 a month.

It’s unclear what will happen if Idaho lawmakers don’t comply with the rule, which Shanahan said is required by the federal government.

Wisconsin revealed some flexibility in the regulation during a health-care standoff with the federal government in 2012 and 2013. The state’s Republican governor, Scott Walker, expanded Medicaid for a small segment of Wisconsinites, but as part of a deal struck with the U.S. Department of Health and Human Services, Wisconsin charges a small premium to adults in the transitional Medicaid track.


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