For the third year in the a row, the Idaho Legislature will pass on Medicaid expansion.
Just days after the House Health and Welfare Committee nearly held a hearing to consider Medicaid expansion to at least some of the projected 78,000 Idahoans who fall in the so-called gap population, legislators took a vastly different path.
On a 39 to 30 vote Wednesday afternoon, House members approved a resolution to study health-care models that could provide care for Idahoans who make too much to participate in Medicaid, but not enough to receive subsidies through Idaho’s insurance exchange.
The plan, sponsored by Rep. Lynn Luker, R-Boise, wouldn’t study full Medicaid expansion as allowed under Obamacare, but would examine the prospect of a modified proposal. Full Medicaid expansion would give coverage primarily to able-bodied working adults who earn less than 100 percent of the federal poverty level each year.
Luker said the House should fully study the idea before diving into a huge policy shift that could cost the state hundreds of millions of dollars in the years to come.
House Democrats offered stiff opposition to the measure.
Rep. John Rusche, D-Lewiston, criticized the plan for addressing health needs too slowly.
“To my mind, it’s clear we have kicked the can down the road,” Rusche said.
Other legislators were less thoughtful. Rep. Dan Rudolph, D-Lewiston, peppered Luker with questions before offering his critique.
“In my mind, the reasons to delay doing this are bogus,” said Rudolph.
That comment drew a mild rebuke from House Speaker Scott Bedke, R-Oakley.
The plan also drew opposition from the House’s more conservative faction. Rep. Ron Nate, R-Rexburg, opposed the bill because he believes it’s the next step to accepting full Medicaid expansion.
Health and Welfare Chairman Fred Wood, R-Burley, planted himself firmly in the middle of his colleagues. Wood said Idaho needs more time to prepare for whatever might come next, and he rejected the idea that Idaho need not do anything for Idahoans in the gap created by Obamacare.
He urged colleagues to view the vote in proper context.
“For the first time, I think we are taking a meaningful step,” Wood said. “I think that’s very important.”
The House, on a 43 to 26 vote, also approved $10.4 million in grants for federally-approved community health centers. Of that amount, $400,000 would fund data collection to help the state learn more about people in the gap. The rest, $10 million, would support community health centers.
Rusche blasted this plan, too, characterizing it as insufficient. He suggested his colleagues “not delude” themselves in believing the grants would fully address the needs of the people in the gap.
House Majority Caucus Chair John Vande Woude, R-Nampa, said while the plan isn’t perfect, it’s a positive step forward that will help health centers provide follow-up and preventative care for the gap population.
“We’re not just going to sit on our hands,” he said.
Both measures now head to the Senate for consideration, which will likely come tomorrow. Legislators want to wrap up their business for the year by the end of the week.
In addition to passing on Medicaid expansion, legislators also rejected Idaho Gov. Butch Otter’s Primary Care Access Program, a $30-million-per-year proposal that would give routine medical care to Idahoans who lack coverage.