In the end, the number that counted most in the Legislature’s debate over health care for the poor was not the 78,000 Idahoans who have no coverage, but the 55 Republicans in the House who on Friday shot down a bill to address that gap.
All but one of the Republicans in the House voted against a Senate-revised bill to act this year. The one who did not was absent.
The 2016 session ended Friday with House votes on two other matters following the 55-12 party-line rejection of a bill to move the state toward a federally approved, Idaho-driven solution on health care for the gap group.
The House approved an $8 million transfer to the Legislature’s legal defense fund — potentially to pay for a settlement in the long-running legal case involving the state’s K-12 broadband network — and a much-amended urban renewal reform bill that supporters say will make the agencies more accountable.
Gov. Butch Otter scheduled his customary end-of-session news conference for Monday and assuredly will be asked whether he might choose to exercise his executive powers to authorize the action on health care the Legislature declined to do. This week, Otter expressed support for prompt action seeking federal approval for an Idaho plan. He also has repeatedly said he would not act unilaterally, but the Legislature has delivered a mixed message on the matter.
Ironically, the Senate-approved health care bill shot down by the House began its short trip around the Capitol last week in the House, emerging from discussions among lawmakers there. For a brief time it had majority support among Republicans. But it did not see daylight until the Senate, on Thursday, used it to completely rewrite a more modest House proposal.
The Senate approved that bill, completed its other business and adjourned Thursday night, leaving the House to vote it up or down Friday morning.
The bill would have authorized the state Department of Health and Welfare to seek a federal waiver for Idaho to customize a plan with federal Medicaid dollars. The state would use a block grant for a managed-care program for the people in the gap group.
Through the session, the House majority tolerated a measure of uncharacteristically public disagreement over how to handle the gap coverage. The end-of-session display of unity showed the high value the majority places on loyalty and discipline. Even a day before the House’s final vote, members of the House Health and Welfare Committee publicly disavowed the course House leadership had plotted, saying they would refuse to act on health care related legislation next year unless progress was made on the waiver.
After lengthy Friday morning caucuses of party leaders and then the rank-and-file, Republicans voted together to not accept the Senate’s amended bill.
“I think we are well aware that the amendments have considerably changed the intentions of the bill,” said Rep. John Vander Woude, R-Nampa, the GOP majority caucus chair. “I can no longer support what’s been added to it.”
Immediately after the House adjourned, Speaker Scott Bedke said he would appoint a joint bipartisan panel of lawmakers to review the gap coverage issue starting in May.
“We have a very clear commitment in the caucus that we will take this issue up with real intent,” Bedke said. “I think that I speak for nearly everyone in the caucus that this is Job 1.”
Minority Leader John Rusche, D-Lewiston, said Democrats would call on Otter to seek the federal waiver using his executive authority or call the Legislature into special session to do it.
Rusche dismissed the idea of another working group, noting previous studies and the failure of last year’s tax working group to produce anything of substance.
“This issue has been studied to death, with professionals who know health care policy and health care finance,” Rusche said. “Maybe we’ll get them to move next year, but in the meantime, Idaho should be disappointed in what Republicans have done to them.”
Although the session did not produce a health care plan, what emerged is consensus among lawmakers that something must be done for uninsured population.
“Not only did this issue make it to the Final Four, but it made it to the championship game, and we ended up going to overtime,” said Brian Whitlock, president and CEO of the Idaho Hospital Association, one of many health care organizations that backed the federal waiver. “And the last-second shot popped out.”