Both lowering Medicaid eligibility requirements and substantially expanding the distribution of Medicaid services in Idaho were among the topics of discussion Friday at the joint meeting of the Senate and the House Health and Welfare committees.

The joint committee, according to the House chairman, Fred Wood, R-Burley, was not convened to conduct actual business on the idea of Medicaid expansion, but only to gather information.

“My first encounter with indigent care was about 1978,” said Rep. Tom Loertscher, R-Iona, as he spoke Friday before a joint hearing of the Idaho House and Senate Health and Welfare committees. Loertscher is promoting legislation that would both eliminate Idaho’s catastrophic health care program (the CAT fund) for uninsured and financially needy residents, while at the same time expanding the number of Medicaid recipients in Idaho, and the amount of federal dollars being transferred in to the state to fund the program.

“It was about 1976 when the counties were put on the hook for providing this kind of care,” Loertscher told the committee. He says that with the expansion of the federally funded Medicaid program, state and local government agencies in Idaho would end up saving money.

At Friday’s joint committee hearing, both Richard Armstrong, director of the Idaho Department of Health and Welfare, and Idaho State Tax Commissioner Ken Roberts, a former Republican legislator, testified in favor of the Medicaid expansion plan. Several representatives of the medical insurance industry also testified in favor of the plan.
As currently outlined, any expansion of Medicaid would be fully funded by the federal government for the initial three years, then the federal funding would drop to 90 percent.

Begun in 1965, the Medicaid program provides certain health care services to individuals and families with low incomes and limited resources. Financed with a combination of federal and state tax revenues, the expanding costs of Medicaid have in recent years become a topic of growing concern among the individual states, despite the eligibility of the program being based on a variety of means testing processes.

A key component of President Barack Obama’s Affordable Care Act law was to have mandated that the individual states reduce eligibility requirements for Medicaid, and expand the number of participants in their respective programs. However, the United States Supreme Court overturned that component of the Obamacare law, so expansion of Medicaid is an elective choice for each of the states.

Last summer, Otter appointed a task force to study the possibility of Medicaid expansion in Idaho. In January of this year Otter spoke of Medicaid in his State of the State address, but noted that “there’s a lot more work to do, and we face no immediate federal deadline. We have time to do this right, and there is broad agreement that the existing Medicaid program is broken. So I’m seeking no expansion of those benefits.”

Loertscher spoke of his Medicaid expansion ideas to the House Health and Welfare Committee on March 14 of this year. On March 18, Otter’s Medicaid task force unanimously recommended that Medicaid be expanded this year.
On March 18, IdahoReporter.com contacted Otter’s office to inquire about the desire for Medicaid expansion and whether Otter’s position on expanding Medicaid this year was changing.

“I disagree with the assertion that the Governor’s position has changed on this issue,” Otter spokesman Jon Hanian said in an email. “What the Governor said in the State of the State address still stands. He has asked Director Armstrong (Richard Armstrong, director of the Idaho Department of Health and Welfare) to flesh out a path forward and believes that the current Medicaid system is broken. The Governor gave Director Armstrong the charge to understand the costs and savings associated with Medicaid expansion and how these would affect the state and our citizens. That research does not end until there is a final determination by the Governor and the legislature on what will be the best course of action for the state.”

IdahoReporter.com also asked Hanian if the legislation to expand Medicaid was what Otter had in mind when he noted in January that the Medicaid system was “broken.” Hanian declined to comment on the matter, noting that the governor does not comment on legislation as it is making its way through the Legislature