Voters approved the expansion — giving Medicaid health insurance to all low-income adults in Idaho — with a 61 percent vote in November.
Instead of funding the expansion or repealing it, the Idaho Legislature took up bills to change it. Lawmakers passed the latest version of their sideboards legislation on Friday, after weeks of intense deliberation. The governor received it Monday.
Little: Medicaid expansion bill ‘innovative’ but has problems
Little said earlier in the session that he wouldn’t allow the Legislature to go home without funding the expansion.
“I appreciate the Idaho Legislature’s innovative approach to expanding Medicaid,” Little wrote in a letter Tuesday announcing that he had signed the bill. “The negotiations with the federal government will be challenging, but I have confidence in my directors of the Department of Health and Welfare and the Department of Insurance and their ability to work with our federal partners and pursue the waiver required to implement this approach.”
Little said he also “strongly” supports the work rules — but has some reservations about how they’ll be carried out.
“We must encourage self-sufficiency among those receiving public assistance,” he wrote. “However, I have concerns regarding the work and training reporting requirements in this bill,” because they have prompted lawsuits in three other states.
He also noted that the legislation “fails to utilize our existing work and training program,” which he said “would streamline more efficient and accurate reporting.”
Little concluded by urging the Legislature to revisit key parts of the bill and address his concerns before or at the start of the 2020 legislative session.
Work requirements need federal waivers
Before the various sideboards can take effect, Idaho must get approval from the U.S. Department of Health and Human Services. The Trump administration has been eager to let states tailor Medicaid to their preferences, including adding work requirements. But a federal judge recently said HHS was wrong when it approved work requirements in Arkansas and Kentucky.
“These are some of the most compassionate work incentives in the nation,” said Rep. John Vander Woude, R-Nampa. “They promote self-sufficiency for everyone on Medicaid, which translates to smart use of tax dollars and financial stability for every Idahoan.”
Pieces of the law Little signed Tuesday faced significant criticism from the public and lawmakers.
During public hearings, almost every person testified against imposing work requirements, putting some people on private insurance, charging co-pays as a penalty for failing to follow work rules, and other sideboards.
Some Republicans disagreed with the measures, too, and broke with their party to vote against them.
House and Senate Democrats issued a statement Tuesday calling the governor’s decision “fiscally irresponsible and inhumane.”
“This legislation is designed to restrict people’s access to Medicaid expansion while costing the state millions every year,” the statement said.