As of Monday, March 28, 2016
BOISE Idaho’s debate on providing healthcare coverage to around 78,000 Idahoans who live without it drew the 2016 legislative session into its eleventh and final week.
The legislature passed nothing. They adjourned last Friday, March 25, shortly after a party-line vote in which the House of Representatives killed the final healthcare proposal introduced this session, which would have appropriated $5.4 million for a grant program to support clinics, and was amended to include a request for a Medicaid waiver that the legislature could consider next year.
Following adjournment, Speaker of the House Rep. Scott Bedke, R-Oakley, told reporters he intends to create a legislative working group to address the 78,000 in the gap.
“The medical services that they receive are inadequate, they’re expensive when they do receive them, it’s an inefficient use of taxpayer dollars, and it has bad medical outcomes,” Bedke said. “This is job one.”
A form of Medicaid expansion was recommended by Governor C. L. “Butch” Otter’s task force on the subject, but was considered by most legislators this year to be a non-starter. Instead, Otter proposed the Primary Care Access Program, which he created with Department of Health and Welfare Director Richard Armstrong and Health and Welfare Committee Chair Rep. Fred Wood. Democrats holding out for Medicaid killed this one, voting with the opposition on a partial funding bill.
Two Medicaid expansion bills from Moscow Democrat Sen. Dan Schmidt were given a public hearing, a first for Medicaid in Idaho, but no vote was taken on them.
In the final week, a waiver bill appeared on a committee agenda for Monday, but was delayed and then finally removed. The bill that kept the House an extra day was originally limited to the grant program, but was amended to add the waiver.
Before the waiver amendment, Health and Welfare Committee members Rep. Kelly Packer, R-McCammon, Rep. Christy Perry, R-Nampa, and Rep. Caroline Nilsson Troy, R-Genessee, came to what was meant to be a short procedural meeting of their committee with prepared letters. With a poor outlook for any substantial gap legislation being passed in the session, the three legislators, and two more on the committee unaware of the prepared letters, pledged that next session they would vote against anything not a Medicaid waiver.
When the House received the amendment for a Medicaid waiver, all five voted with the rest of their party to kill it. Perry said she knew it would not have the votes, so she voted with the others to maintain “cohesion” going into next year.
Despite the legislature not coming any closer to what he would consider a solution, Schmidt said the session was a win-win for him.
“It got addressed,” Schmidt said. “I was very surprised it got any traction at all.”
Doing something about the gap population has drawn bipartisan support in the legislature this session. Of those in the gap that the department has data on, 65 percent are employed. Armstrong said the reason so much support exists is because their data broke stereotypes of the people in the gap.
Opposition has come from a political discomfort against the Affordable Care Act, caution about expanding Medicaid if the next president leads to a repeal of the law and, according to some, the coming state primary elections.
In one of the last meetings of the Health and Welfare Committee, accusations flew against both parties that their statements were for the purpose of campaigning.
“I would bet that if we did this after primary elections, things might be different,” said Minority Leader John Rusche, D-Lewiston, after adjournment on Friday.