State Politics

Senate Republicans push forward with adding work requirements to Medicaid expansion

Veteran’s health care is covered. His wife falls into the Medicaid gap.

Disabled Idaho veteran Josh Blessinger describes his wife's painful health issues during a July 6, 2018 rally delivering petitions for a public vote on Medicaid expansion.
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Disabled Idaho veteran Josh Blessinger describes his wife's painful health issues during a July 6, 2018 rally delivering petitions for a public vote on Medicaid expansion.

When the Idaho Senate came to order on Monday morning, it seemed that the work requirements many Idaho Republicans wanted to tack on to voter-approved Medicaid expansion might be dead in the water.

After all, a federal judge last week struck down such work requirements in Arkansas and Kentucky.

But the Republicans pressed on, undeterred. Senators on Monday introduced a series of amendments to an existing bill, basically cobbling together a new measure that includes some of the most controversial sideboards for Medicaid expansion — none of which were contained in Proposition 2, the initiative passed by 61 percent of voters last fall.

Here’s what the Idaho Legislature’s new frontrunner bill would add to Medicaid expansion, which takes effect next January. The full Senate still must approve the amended version of the bill; and after that, the House.

  • Idaho would seek a waiver to let some people get private insurance, paid for by the federal government. Under this proposal, people who qualify for expanded Medicaid but have incomes slightly above poverty level would have the option of obtaining insurance through the state’s exchange, Your Health Idaho. This amendment was proposed by Sen. Fred Martin, R-Boise.

    Read more: What’s the difference between private insurance and Medicaid? A lot.
  • Low-income adults who qualify for Medicaid expansion would have to work, volunteer or go to school. Unlike the work requirements that have been discussed in Idaho and other states, failure to comply wouldn’t mean losing Medicaid. People still would have coverage. They would just have a co-pay imposed on them — such as $5 to $30 for a doctor’s appointment — until they complied. Some people would be exempt, such as parents, caregivers and those filing for disability. This amendment came from Sen. Steven Thayn, R-Emmett.

    Read more: The fate of Idaho Medicaid expansion comes down to 2 words: work requirements
  • There would be a trigger clause to keep Idaho from losing out on federal funds. If the federal government grants a waiver associated with Medicaid expansion, but on the condition that it drops the federal share for expansion costs below 90 percent, the state wouldn’t be authorized to carry out that waiver. This amendment was introduced by Sen. Brent Hill, R-Rexburg.
  • People on expanded Medicaid would have their health care provided and managed by a “medical home,” such as a primary care clinic. Specifically, the amendment introduced by Sen. Mary Souza, R-Coeur d’Alene, would require a referral to get family planning services outside of the medical home.
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