Idaho Senate OKs bill to add Medicaid work requirements

April 2, 2019

BOISE, Idaho (AP) — The state Senate on Tuesday approved legislation adding work requirements to Idaho’s voter-approved Medicaid expansion law.

The chamber voted 20-15 to send the legislation to the House. A similar bill from that chamber died last week in a Senate committee.

The current bill is an attempt to reach a compromise that can win the approval of Republican Gov. Brad Little. It wouldn’t kick people off Medicaid, as the House bill called for, if they don’t fulfill the work requirements.

“This bill does not drop anyone off of Medicaid expansion,” Republican Sen. Mary Souza told fellow lawmakers. “At no time will they lose their coverage.”

Voters authorized Medicaid expansion in an initiative in November with 61% of the vote after years of inaction by the Legislature.

The expansion will provide access to preventative health care services for an estimated 91,000 low-income residents. The federal government would cover 90% of the estimated $400 million cost.

The Senate previously passed an appropriations bill paying for Medicaid expansion as approved by voters with no work requirements. Little has included $20 million for the expansion in his budget.

However, the House has refused to vote on the appropriations bill. Instead, it passed a measure with penalties that would kick people off Medicaid after 60 days if they didn’t meet work requirements.

The Senate bill requires able-bodied Medicaid recipients who fail to meet the work requirements to make a copay when seeking medical services, but it does not kick them off Medicaid. The number of people who might fall under the work requirement is estimated at 12,000.

Republican Sen. Jim Rice defended the provision.

“If you’re really, really available and able-bodied, get a job or help pay for it,” he said. “Don’t just freeload on your neighbors.”

The bill would also seek a waiver from the federal government to allow people earning 100 to138 percent of the federal poverty level to stay on the state’s health insurance exchange rather than go on Medicaid if they choose.

Backers of the legislation say the work requirement and the insurance waiver could save the state several million dollars.

Democratic Sen. Maryanne Jordan said administering the work requirements as well as other aspects of the legislation will “take more money out of the general fund on a yearly basis than” the law without work requirements approved by voters.

Last week, a federal judge in Washington blocked Medicaid work requirements in Arkansas and Kentucky.

The judge ruled that the requirement for low-income people posed numerous obstacles to getting health care that hadn’t been adequately resolved by federal and state officials.

That ruling appeared to play a part in sinking the House’s Medicaid expansion bill. Some senators on Tuesday argued that the Senate version of Medicaid expansion also runs afoul of that ruling.