State Politics

Idaho Supreme Court upholds Medicaid expansion, rejects Idaho Freedom Foundation suit

Idaho Supreme Court hears arguments regarding the legality of Medicaid expansion

The Idaho Supreme Court hears arguments Jan. 29, 2019, regarding the legality of Medicaid expansion, an initiative that passed on the November 2018 ballot with 61 percent of the vote.
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The Idaho Supreme Court hears arguments Jan. 29, 2019, regarding the legality of Medicaid expansion, an initiative that passed on the November 2018 ballot with 61 percent of the vote.

The Idaho Supreme Court on Tuesday said that Medicaid expansion, passed by voters as ballot Proposition 2, is legal.

The court ruled against the Idaho Freedom Foundation in its lawsuit, which argued that Prop 2 was written in a way that gave too much power to the federal government and the Idaho Department of Health and Welfare.

Medicaid expansion will make Idaho’s working poor — those in the “Medicaid gap” — eligible for public health insurance in 2020.

The ruling came just one week after the court heard arguments from both sides: the Idaho Freedom Foundation and the state. The court also heard from a lawyer representing Idaho physicians and two Idaho women who would qualify for expanded Medicaid.

The IFF argued that, among other things, the ballot measure ceded Idaho’s decision-making authority to the federal government because it referenced federal law. Why would that matter? The conservative think tank’s attorney said that would lock Idaho into paying for Medicaid expansion even if the federal government pulled its own funding.

The court’s majority opinion called the argument “unpersuasive” and noted that “many Idaho statutes reference federal law.”

“In fact, Idaho’s existing Medicaid statute, even prior to expansion, incorporates federal law to determine eligibility,” the opinion said. “If we were to accept [the IFF’s] argument that any reference to a federal statute delegates lawmaking authority to the federal government, then many of Idaho’s statutes would be unconstitutional, and in fact, the option of any cooperative federal-state program would be curtailed.”

About 61 percent of Idaho voters approved the law. It allows people who make less than 138 percent of poverty-level income to qualify for Medicaid coverage, even if they don’t have children or a disability.

The Idaho Attorney General’s Office had argued that the lawsuit — brought by IFF board chairman Brent Regan — lacked merit and was “frivolous, unreasonable and without foundation on several levels.” The AG’s office was so adamant about the frivolity of IFF’s claims that it argued the conservative group should have to pay the state’s defense costs. The Idaho Supreme Court decided that wasn’t warranted.

The lawsuit isn’t the only challenge Medicaid expansion is facing in Idaho.

After being sworn in, Gov. Brad Little vowed to uphold the will of the voters and to support the expansion of Medicaid. But he and state legislators have discussed possible restrictions, such as work requirements. Lawmakers also must decide how to fund the expansion. Idaho would pay 10 percent of the cost, and federal funding would cover the remaining 90 percent — a much larger share than the federal government has covered for traditional Medicaid in Idaho.

The Idaho Department of Health and Welfare expects to submit its plan for expansion to federal officials by Feb. 18.

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Watchdog reporter Audrey Dutton joined the Statesman in 2011. Before that, she covered municipal finance policy in Washington, D.C., during the financial crisis. That gave her a fondness for stories about money and powerful institutions. Audrey grew up in Twin Falls.If you like seeing stories like this, please consider supporting our work with a digital subscription to the Idaho Statesman.

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