Latest news with #HouseBill138
Yahoo
04-03-2025
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An Idaho ‘reform' bill would likely repeal voter-approved Medicaid expansion. Here's why.
Idaho Gov. Brad Little gives his annual State of the State address on Jan. 6, 2025, on the House floor at the Statehouse in Boise. (Pat Sutphin for the Idaho Capital Sun) For years since voter-approved Idaho Medicaid expansion took effect in 2020, Republican state lawmakers have pointed to the program's rising costs as a reason for reform. Two weeks ago, as Idaho House lawmakers debated and narrowly passed a Medicaid expansion reform-or-repeal bill, many critics said it would effectively repeal Medicaid expansion — because Idaho couldn't get federal approval for the proposed policy changes in time. The bill, House Bill 138, by Rep. Jordan Redman, would demand 11 policy changes to Idaho Medicaid. If the bill becomes law, Idaho failing to implement a single one of its 11 policy demands by July 2026 would trigger a repeal of Medicaid expansion in Idaho. Medicaid expansion, approved by nearly 61% of Idaho voters via ballot initiative, extended Medicaid coverage to a population commonly called the 'working poor' that fell in a health care assistance gap. Idaho has already attempted — or to some extent, already adopted — five of the bill's 11 proposed policy changes, an analysis by Idaho Voices for Children found. Idaho Legislature introduces tweaked Medicaid cost bill, with work requirements The remaining six would be new to Idaho. Other states failed to receive federal approval or never tried for many of them, the analysis found. Ten of the 11 policy changes in Redman's bill require federal approval, the analysis found. Idaho already tried to implement two similar policy changes — work requirements, and an option for the state-based insurance exchange — which were not approved by the Trump administration during President Donald Trump's first term in office that ended in early 2020. On top of the mixed historical success states have had getting federal approval on similar policy changes as Redman's bill proposes, the bill's timeline is too fast, critics say. 'It's simply not enough time to even go through the waiver process and public comment period — not to mention implement at the state level — by the deadline given,' Hillarie Hagen, senior policy associate at Idaho Voices for Children, told the Idaho Capital Sun in an interview. Agreeing the bill would likely repeal Medicaid expansion, Senate Health and Welfare Committee Chairwoman Julie VanOrden, R-Pingree, has stopped the bill from advancing in the Senate. But on Thursday, Sen. Glenneda Zuiderveld, R-Twin Falls, unsuccessfully tried to schedule the bill for a hearing in committee — citing the rising costs of Medicaid and the bill's House passage. In her newsletter, Zuiderveld said she'll continue trying to advance the bill this year. SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX Redman, a Republican from Coeur d'Alene, says the bill is intended to reform, not repeal, Idaho Medicaid expansion by adding accountability to control the program's budget. He says federal approval of his bill's provisions is likely, suggesting that the new Trump administration is different. 'As far as new things being done, I don't think we've ever seen an administration move as fast and do as many new things as we're seeing this year,' he told the Sun in an interview. Trump supported a congressional budget plan that critics say would massively cut Medicaid. All but one U.S. House Republican passed the plan last week, with a slim majority over the opposition of all Democrat U.S. House lawmakers, States Newsroom reported. But Trump has assured Republicans won't 'touch' Medicaid, Medicare or Social Security. Speaking to reporters last week, Idaho Gov. Brad Little said he doesn't say what he'll do with a bill until it arrives on his desk. The governor said he's in favor of controlling Medicaid's costs, but he acknowledged Medicaid expansion 'was passed overwhelmingly by the public.' He hadn't fully read the bill, he said, 'but I've read enough of it to know I've had concerns.' But Little expressed optimism the new Trump administration would grant more Medicaid waivers. Last week, Redman and other Idaho lawmakers introduced a Medicaid cost-control bill — without an expansion repeal trigger. If House Bill 138, the Medicaid repeal-or-reform bill, becomes law, Idaho successfully implementing all of the bill's policies would mean kicking tens of thousands of Idahoans off Medicaid expansion. CONTACT US One of the bill's provisions would cap Medicaid expansion enrollment at 50,000 people, or less than all disabled and senior Idahoans on Medicaid — whatever is lower. Asked how many disabled and senior Idahoans are on Medicaid by another lawmaker on the House floor, Redman said about 35,000 people. Medicaid enrollment can change over time. But if the bill took effect now, that provision alone would cut off Medicaid expansion access to more than half of Idahoans currently enrolled — which is about 89,300 people, according to state health figures. Another provision in the bill would make people ineligible for Medicaid expansion after three years of being on the program. On average, Idahoans spend almost five years on Medicaid, state health data show. But Idahoans only spend about nine months on Medicaid expansion, on average, according to a report released late last year by Idaho Voices for Children. In 2016, before Idaho voters approved Medicaid expansion, Dr. Kenneth Krell told an Idaho legislative committee lawmakers had killed about 1,000 Idahoans over three years by refusing to expand Medicaid. Krell, a former ICU director in eastern Idaho, advocated for Idaho Medicaid expansion after one of his patients died. He says her death was preventable. If Idaho repeals Medicaid expansion, 'a whole lot of people are going to die,' he told the Sun in an interview. He isn't sure how many. But he says primary care doctors will feel how patients are impacted. 'Because suddenly those patients are unable to access the care they've been receiving because they're no longer funded,' Krell said. 'And a lot of those patients are just going to quietly disappear.' And he believes the Legislature knows the bill would end Medicaid expansion. It 'kind of gives them a quieter way to do that' than a straight-forward repeal bill, Krell said. Research has found lower mortality rates in states that expanded Medicaid. A 2022 study found states that expanded Medicaid had lower mortality rates 'from any cause after Medicaid expansion than in non-expansion states.' Debating the bill on the House floor, Idaho House Minority Leader Ilana Rubel, D-Boise, said before Idaho expanded Medicaid, tens of thousands of Idahoans were in a coverage gap. 'People were dying of preventable illnesses,' she said. 'It was not a magical wonderland here before we passed Medicaid expansion, where people just pulled … themselves up by their bootstraps, and everybody had coverage, and everybody just worked that much harder,' Rubel said. '… It was terrible.' In 2019, the Idaho Legislature passed a bill requiring Health and Welfare to seek a range of federal Medicaid waivers, including work requirements for able-bodied adults on expansion and giving expansion-eligible Idahans the option to receive tax credits for insurance on Idaho's health exchange, Your Health Idaho. In August 2019, a month after Idaho submitted Idaho's insurance exchange option waiver application, the federal Centers for Medicare and Medicaid Services, or CMS — then under the first Trump administration — denied it. Idaho's application 'contains no information to support a conclusion that the proposed … waiver would not increase the federal deficit,' CMS wrote. Fuhriman, the representative from Shelley, doesn't agree that waiver would actually increase costs for the federal government. 'To the federal government, 90% is less than 100%. Therefore, they're not (deficit) neutral,' he said. 'Pretty stupid, right?' Idaho's work requirement waiver is still listed as pending by CMS. Redman's proposed work requirement is more stringent than Idaho's law that spurred the state's pending work requirements application, the Idaho Voices for Children analysis says. If passed, Redman's bill would take effect in July. By October, Idaho state agencies would be required to submit to the federal Centers for Medicare and Medicaid Services, or CMS, waivers for the bill's proposed policies. If those policies aren't in effect about 10 months later, by July 2026, Idaho Medicaid expansion would be repealed. Repealing expansion also requires federal approval, lawmakers say. Redman told the Sun his bill leaves a lot of the process in the hands of the Idaho Department of Health and Welfare. But he said the agency can package together many of the policies into one waiver. Lumping together the conditions into one waiver would add complexity and time needed for federal review, Hagen told the Sun. 'For something of that magnitude, you're likely looking at something a year and a half or more,' she said. 'There is zero chance that every single one of them passes and meets rules to satisfy requirements,' Hagen told the Sun. Redman understands the bill's timeline is ambitious. But he thinks the federal government is moving at record speed. 'We've never seen that. And good or bad, we've seen speed right now. We have seen efficiencies, and so I think that's what we're going to see on these waivers, too,' Redman told the Sun. Asked about how several of his bill's policies haven't been attempted, Redman said 'Idaho needs to take the lead.' 'We're not the only state that's dealing with this,' he told the Sun. 'So I think that (federal regulators) are highly likely to really approve these waivers and let this model play out in our state.' Redman, a second-term North Idaho lawmaker, co-owns a health insurance company and several pharmacies. He told the Sun his insurance company only has one policy on Idaho's insurance exchange — saying the bill's passage wouldn't impact him. Rep. Ben Fuhriman, a first-term Republican lawmaker from Shelley and a financial planner and health insurance agent, opposed the bill — saying it would repeal Medicaid expansion. 'In my personal opinion, my belief — there is 0% chance that all 11 of these waivers get approved and implemented in the timeline,' he told the Sun in an interview. The day Fuhriman first saw the bill, he stayed up until 2 a.m., studying how CMS has reviewed states' Medicaid waivers, he told the Sun. When Idaho lawmakers return next January for the 2026 legislative session, Redman says they could revisit the bill before the repeal trigger would take effect. 'There's time to see what kind of movement we have on this. I mean, again, this is a goal to save the program. And I'm willing to do whatever that takes to save the program,' Redman told the Sun. 'I do want urgency from the federal side. I think we're going to see that.' The bill also requires several administrative changes to broader Medicaid policy — not related just expansion — to avoid triggering a repeal of expansion. 'Those elements of the bill have not been attempted before in other states and have a lot of legal questions,' Hagen told the Sun. Hagen agreed the Trump administration is looking for new ways to change the Medicaid program. But she said Redman's bill's proposed waivers 'are not necessarily creative or innovative.' 'They simply just take people off of the program,' she told the Sun. Several of those waivers, she said, violate federal rules that state 'these waivers (types) must expand coverage and increase access to the program or healthcare services.' 'Even if the Trump administration has a desire to approve some of these requirements, they still don't meet waiver rules. And if approved, will likely end up in federal court, as many other state waivers have,' Hagen told the Sun. Fuhriman said he doesn't think work requirements alone can be approved. 'The thing that people don't realize, I think, in this, is that this isn't the Trump administration that gives these waivers willy nilly. It's — it's law,' Fuhriman said. 'And some of these waivers are built into the Affordable Care Act. The changes they're trying to make — the only way that they could approve those changes would be for Congress to come in and change the law.' Speaking to reporters last week, Little, Idaho's governor, seemed more optimistic about the prospect of federal approval. He said he guarantees there are going to be more Medicaid waivers. Asked how the Trump administration could grant waivers previously rejected, Little suggested federal legal interpretations might change. 'We shall see. The one thing I will tell you about Donald J. Trump is he doesn't mind pushing the envelope on some of those,' Little told reporters. 'And I know that's a real shocker to everybody in this room.' CMS, which evaluates states' Medicaid waivers, did not reply to a request for comment from the Sun about the likelihood of Redman's bill's demands receiving federal approval. A spokesperson for the Idaho Department of Health and Welfare declined to comment on the likelihood of federal approval for the proposed waivers, saying the agency does not comment on pending legislation. Trump officials' mass firings of federal workers, spurred by billionaire Elon Musk's Department of Government Efficiency, or DOGE, led to layoffs of federal health officials, including at CMS, Politico reported. To Hagen, those layoffs are likely to extend the time needed to review waivers. SUPPORT: YOU MAKE OUR WORK POSSIBLE
Yahoo
21-02-2025
- Health
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Idaho's House Bill 138 threatens voter-approved Medicaid expansion
Montana's redetermination dashboard cites the most frequent reason for disenrolling as a lack of correspondence with the department. (Getty Images) Sometimes, it seems the Idaho Legislature treats residents more like badly behaved children than the people who hired them. Case in point: The proposal to change the state's Medicaid expansion program, which was put in place after 61 percent of voters passed it in 2018. By one vote, House Bill 138 by Rep. Jordan Redman, R-Coeur d'Alene, passed out of the House Health and Welfare Committee on Feb. 12. The measure passed in the House 38-32 on Feb. 19 and is now in the Senate. At best, this is a raspberry blown to state voters in the guise of saving money. But can it really save as Redman says? Looking to the long-term, erasing Medicaid expansion can cost the state millions of more dollars than it saves. Why? Medicaid is an insurance program for the very poor, and currently, Idaho's Department of Health and Welfare reports 450,000 residents are covered by Medicaid, including the 89,000 enrolled in the expansion. These are families of four or more who make less than $3,193 a month or individuals who make less than $1,563 a month and have no insurance from their employers. The problem with eliminating such coverage for the poor is they will wait until a simple illness becomes severe before being seen by medical professionals. By waiting for care because they cannot afford it, their medical problem becomes worse and they need more – not less – care and costs. Often this care needs to be subsidized by the state. Nationwide, the Kaiser Family Foundation estimates that poor families (making less than $40,000 per year) hold about $195 billion in medical debt. This can further deter people from seeking medical help. This means the state is creating a hole many residents cannot dig their way out of thanks to low wages and steep medical bills. Add in, the Department of Health and Welfare reports 24 percent of the individuals covered have a primary diagnosis of a serious mental health issue. Medicaid allows these people to access a wider range of behavioral health services so they can get proper treatment. As for saving the state money, Idaho Health and Welfare reports hospitals spent $42 million less on charity care and had $61 million less debt during the COVID pandemic. That translates into state savings as people who might become sicker were provided with quality care. This is all thanks to the 2018 Medicaid expansion. Report: Federal funds for Idaho Medicaid expansion spurs $1.5 billion in economic output Redman's bill would require Idaho to enact 11 Medicaid policy changes or repeal the voter-approved expansion. Some of Redman's changes include work requirements, capping expansion enrollment, a three-year lifetime limit of access to the program along with possibly repealing the expansion altogether. If House Bill 138 is passed, the state will still need approval of the federal government for many of the proposed changes. While Redman claims his bill does not eliminate Medicaid expansion, the measure does clearly repeal the expansion if the elements of the bill are not in place and functioning by July 2026. Redman called the proposal the 'bullets in the gun to kind of force them a bit.' Redman later apologized for the analogy, but it did indicate his intention to pressure the federal government into allowing the state change. During testimony before the House committee, the comments were overwhelmingly negative. Idaho Press journalist Laura Guido reported several people who opposed the bill were concerned this would be a cause for full repeal in addition to the threat of leaving thousands of people without insurance triggering higher costs to the state, counties and health systems due to the expected delays in preventative care. As Dr. Kelly McGrath of Orofino told the committee, such health care is not only cost-effective, but also a lifeline for many families who have difficult medical conditions. By providing care, McGrath said those patients can strengthen rural communities because they can be productive citizens. While the bill's proponents say they want something to encourage people to work, people with serious medical (physical or mental) conditions who cannot receive care have difficulty finding a job, much less retaining one. Medicare expansion may not be everyone's cup of tea, but keeping it in place is indeed a lifeline for thousands of Idahoans who can get the care they need so they can work and keep their families together. SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX
Yahoo
20-02-2025
- Health
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‘One accident away from bankruptcy': Idaho House passes bill to gut Medicaid expansion
When a bill that could slash health care coverage for tens of thousands of low-income Idahoans was introduced in the Legislature, Rep. Megan Egbert, D-Boise, said she got an angry voicemail from a farmer in Central Idaho who mistakenly thought she supported the measure. Long bemoaned by many Republicans, whose inaction led state voters to approve Medicaid expansion in an initiative in 2018, the program was freshly targeted this year. House Bill 138, sponsored by Rep. Jordan Redman, R-Coeur d'Alene, would cut off Medicaid expansion unless a set of 11 conditions are met — several of which would require federal approval that historically has not been forthcoming. House Bill 58, sponsored by Rep. Josh Tanner, R-Eagle, would repeal Medicaid expansion outright. It was HB 138 that the Central Idaho man was upset about. Egbert said on the House floor Wednesday that having exclusively received feedback from people opposed to the bill, she informed him that she was, in fact, against it. And if legislators voted to move the bill along, they should expect a call from that farmer. Lawmakers' phones could be ringing soon — the bill passed the House by a 38-32 vote, earning quick condemnation from minority Democrats. 'It winds us back to a time when tens of thousands of Idahoans were one accident away from bankruptcy and losing everything they had,' said House Minority Leader Ilana Rubel, D-Boise. Redman said at a public hearing that his proposal aims to rein in Medicaid spending and prevent what Republicans have said are 'skyrocketing' costs. He asserted that his bill would simply introduce guardrails but keep the program alive. 'This bill does not kill Medicaid expansion,' he said. But outside experts and even some Republican lawmakers said meeting all 11 conditions required to maintain the program has little chance of happening, the Statesman reported. Those include limiting the number of participants to 50,000 enrollees, adding work requirements, capping program participation at three years and cutting down on improper payment rates. Overall, more than half of the conditions would require waivers from the Centers for Medicare and Medicaid Services. The result is that the bill effectively just becomes a repeal of voter-approved expansion — but Rep. Wendy Horman, R-Idaho Falls, said Wednesday she was 'willing to take the risk.' 'I think the risk of not acting leaves us in a very vulnerable position,' she said. The Affordable Care Act, passed in 2010, required states to expand Medicaid coverage to continue receiving federal funding, but the U.S. Supreme Court struck down that requirement in 2012, leaving it to individual states to decide whether to broaden the list of qualified recipients. The GOP-dominated Idaho Legislature never did expand offerings to those in the so-called coverage gap — they earned too much to qualify for standard Medicaid but not enough for private insurance discounts. The number of Idahoans in this gap numbers about 90,000, according to the Idaho Department of Health and Welfare. This led Idaho residents to bring forth a successful ballot measure in 2018, and Medicaid expansion has been in place in Idaho since then. HB 138's supporters say the cost of the program 'is not sustainable,' to use Horman's words. Rep. John Vander Woude, R-Nampa, said in a January hearing that the program's expected costs for the state went way beyond what lawmakers expected: from $32 million in projected costs in 2018 to $110 million in fiscal year 2026. The federal government, however, pays 90% of the costs of Idaho's Medicaid expansion, but Republican lawmakers have repeatedly said the Trump administration might lower the payment threshold as it targets federal spending. At a public hearing last week, more than 300 people signed up to testify against Redman's bill compared to just 17 who signed up in favor — about an 18-to-1 ratio. The House Health and Welfare Committee then advanced Redman's bill by a single vote, with five Republicans joining two Democrats in opposition. Now narrowly passed by the House, with 23 Republicans joining all nine Democrats to vote against, the bill heads to the Senate for consideration. Tanner's bill has yet to have a public hearing. What might happen in Idaho without Medicaid expansion was still an open question Wednesday. Counties might need to cover the cost of indigent residents' medical bills, said Rep. John Weber, R-Rexburg. He also wondered whether the private sector might extend coverage to people previously in the expansion program. Without a clear plan, Rubel warned that Idaho was simply returning to the 'terrible' time before voters OK'd Medicaid expansion in 2018. 'Spoiler alert: It was not a magical wonderland here before we passed the Medicaid expansion, where people pulled themselves up by their bootstraps and everybody had coverage, and everybody just worked that much harder,' she said. Tens of thousands of people couldn't get coverage, Rubel said, and 'people were dying from preventable illnesses.' Idaho residents on Medicaid, doctors bemoan GOP efforts to repeal citizen-led expansion Republicans take aim at Idaho Medicaid expansion. Democrats call bill a 'total disconnect'
Yahoo
15-02-2025
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Legislative Notebook: Bill could have major implications for Medicaid expansion, passes by one vote
A hallway in the Idaho State Capitol Building in Boise as seen on Jan. 7, 2025. (Pat Sutphin for the Idaho Capital Sun) In an effort to help Idahoans follow major bills, resolutions and memorials through the legislative process, the Idaho Capital Sun will produce a 'legislative notebook' at the end of each week to gather information in one place that concerns major happenings in the Legislature and other news relating to state government. To receive the full extent of our reporting in your inbox each day, sign up for our free email newsletter The Sunrise on our website at Here is our quick rundown of the major happenings during the sixth week of the Idaho Legislature's 2025 session. One of the most consequential bills of the session passed the Idaho House Health and Welfare Committee on Wednesday by just one vote. House Bill 138, sponsored by Rep. Jordan Redman, R-Coeur d'Alene, would require the state to make 11 Medicaid policy changes or repeal Medicaid expansion — a law passed by Idaho voters via ballot initiative in 2018 with nearly 61% of the vote. Despite overwhelming testimony in opposition to the proposal from voters, doctors, patients who rely on Medicaid for their health insurance coverage, child advocates and disability advocates, the committee voted 8-7 to advance the legislation to the full Idaho House for consideration. Five Republicans joined the committee's two Democrats to vote against it. 'Today, you may hear testimony saying that this bill is a sneaky way to repeal Medicaid expansion. And that's simply not the case,' Redman told the committee as the hearing on Wednesday began. 'This bill is taking Medicaid expansion, putting accountability measures in place and cutting waste to make sure that the state is being the best stewards as we can be for taxpayer funds.' Redman's bill would require that recipients work if they are able-bodied, cap how many Idahoans could enroll in expansion, and kick people off Medicaid expansion after three years. But some who oppose the bill said many of the 89,300 Idahoans who have health insurance through Medicaid expansion do have jobs and that the bill is so onerous that it would effectively function as a repeal of a voter-approved law. And some who testified – and one Republican on the committee – worried that repealing Medicaid expansion would create more hardship for rural hospitals and clinics already facing worrying financial problems. 'This is not a reform bill. This will kill Medicaid expansion,' said Rep. Marco Erickson, R-Idaho Falls, the committee's vice chair. 'And those rural clinics will be the number one first places to go.' Dr. Brandon Mickelsen, representing the board of directors for the Idaho Academy of Family Physicians, urged the committee to oppose the bill. 'These medical costs won't go away if you repeal Medicaid expansion,' Mickelsen said. 'You will create enormous costs for rural hospitals and local communities.' House Bill 93: Co-sponsored by Rep. Wendy Horman, R-Idaho Falls; Senate Majority Leader Lori Den Hartog, R-Meridian; House Majority Leader Jason Monks, R-Meridian; and Sen. C. Scott Grow, R-Eagle, the bill provides a refundable tax credit up to $5,000 for a parent of homeschooled or private school students to pay for expenses including tuition and fees, tutoring, textbook costs, curriculum and transportation. The refundable tax credit is increased to $7,500 for special needs students. The Senate Local Government and Taxation Committee advanced the bill to the full Idaho Senate with a recommendation that it pass, and it may be taken up by the Senate in the coming days of the session. House Bill 83: Sponsored by Rep. Jaron Crane, R-Nampa, the bill would create a new crime known as illegal entry and allow local law enforcement to engage in immigration enforcement. The Idaho House voted 61-9 on Monday to pass the bill. It may be taken up by the Senate State Affairs Committee in the coming days of the session. House Bill 26: Sponsored by Idaho State Treasurer Julie Ellsworth, the bill would allow people with disabilities to establish ABLE accounts. 'ABLE,' an acronym for Achieving a Better Life Experience, allows people with disabilities who collect Social Security Income to save money for future qualifying needs, such as transportation, housing or medical expenses. The Idaho House voted 56-13 on Monday to pass the bill. It may be taken up by the Senate Health and Welfare Committee in the coming days of the session. Senate Concurrent Resolution 103: Co-sponsored by Sens. Ali Rabe, D-Boise; Ben Towes, R-Coeur d'Alene; Carl Bjerke, R-Coeur d'Alene; and Rep. Jordan Redman, R-Coeur-d'Alene; the resolution would establish a bipartisan working group to study housing availability and affordability, as well as land use regulations that affect housing. The Idaho Senate voted 23-10 on Monday to pass the resolution. It may be taken up by the House Local Government Committee in the coming days of the session. Senate Bill 1025: Sponsored by Sen. Dave Lent, R-Idaho Falls, the bill would expand the state's Empowering Parents program to up to $50 million per year. The bill was amended in the Idaho Senate on Wednesday, resulting in the removal of $30 million for special education funding. On Friday, the Senate voted down the bill 6-28. House Bill 7: Sponsored by Rep. Bruce Skaug, R-Nampa, the bill would create a $300 minimum fine for adults convicted of possessing three ounces or less of marijuana. The Senate Judiciary and Rules Committee advanced the bill on Monday to the full Idaho Senate with a recommendation that it pass. It is on the Senate's third reading calendar and may be taken up in the coming days of the session. House Bill 96: Sponsored by Rep. Heather Scott, R-Blanchard, the bill would limit the kinds of flags a government entity can use on its property. The Idaho House State Affairs Committee voted to advance the bill to the full Idaho House with a recommendation that it pass. It is on the House's third reading calendar and may be taken up in the coming days of the session. House Bill 32: Sponsored by Sen. Brian Lenney, R-Nampa, and Rep. Robert Beiswenger, R-Horseshoe Bend, the bill would prohibit local governments, health districts and school districts from mandating that an individual must wear a mask or face covering to prevent the spread of an infectious disease. The Senate State Affairs Committee voted to advance the bill to the full Idaho Senate with a recommendation that it pass. It is on the Senate's third reading calendar and may be taken up in the coming days of the session. House Bill 231: Sponsored by House Majority Leader Jason Monks, R-Meridian, the bill would increase the tax credit Idahoans receive on groceries from $120 to $155. The Idaho House voted 61-6 on Friday to pass the bill. It may be taken up by the Idaho Senate in the coming days of the session. Week 6 Senate Judiciary and Rules Committee Senate Bill 1101: Sponsored by Sen. Melissa Wintrow, D-Boise, the bill would set consistency standards for death investigations conducted by coroners. It will get a full public hearing in the committee on Monday. House Resources and Conservation Committee House Joint Memorial 4: Sponsored by Rep. Jerald Raymond, R-Menan, the memorial calls upon the federal government to delist grizzly bears and review the Endangered Species Act. It will get a full public hearing in the committee on Monday. House Judiciary, Rules and Administration Committee House Concurrent Resolution 10: Sponsored by Rep. Jordan Redman, R-Coeur d'Alene, the resolution makes three separate applications to the U.S. Congress to call a convention of the states under Article V of the U.S. Constitution. It will get a full public hearing in the committee on Monday. 'Every single legislator had a jaw dropping moment of surprise, shock — because they just didn't know. I think every single one of them said, 'Now what? What are we going to do about this?' And to the coroners' credit, they gathered this summer and put this bill together.' – Sen. Melissa Wintrow, D-Boise, on Senate Bill 1101, which follows an Idaho Office of Performance Evaluations report released in 2024 that found inconsistencies in death investigations across Idaho, driven by sparse guidance in state law SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX How to follow the Idaho Legislature and Idaho Gov. Brad Little's work during the session Here are a few tools we use to track the Legislature's business and how to let your voice be heard in the issues that matter most to you. How to find your legislators: To determine which legislative district you live in, and to find contact information for your legislators within that district, go to the Legislative Services Office's website and put in your home address and ZIP code. Once you've entered that information, the three legislators – two House members and one senator – who represent your district will appear, and you can click on their headshots to find their email address and phone number. How to find committee agendas: Go to the Idaho Legislature's website, and click on the 'all available Senate committee agendas' link and the 'all available House committee agendas' link on the right side of the website. How to watch the legislative action in committees and on the House and Senate floors: Idaho Public Television works in conjunction with the Legislative Services Office and the Idaho Department of Administration through a program called 'Idaho in Session' to provide live streaming for all legislative committees and for the House and Senate floors. To watch the action, go to and select the stream you'd like to watch. How to testify remotely at public hearings before a committee: To sign up to testify remotely for a specific committee, navigate to that committee's webpage, and click on the 'testimony registration (remote and in person)' tab at the top. How to find state budget documents: Go to Legislative Services Office Budget and Policy Analysis Division's website How to track which bills have made it to Gov. Little's desk and any action he took on them (including vetoes): Go to the governor's website You can scroll down to the bottom of the site and enter your email address to get alerts sent straight to your inbox when the page has been updated. Reporting from Idaho Capital Sun journalists Clark Corbin, Mia Maldonado and Kyle Pfannenstiel and Idaho Reports journalist Ruth Brown contributed to this legislative notebook. SUPPORT: YOU MAKE OUR WORK POSSIBLE
Yahoo
13-02-2025
- Health
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Idaho bill that could repeal Medicaid expansion advances to House, despite negative public testimony
Rep. Jordan Redman, R-Coeur d'Alene, on the Idaho House floor on March 25, 2024. (Kyle Pfannenstiel/Idaho Capital Sun) By one vote, the Idaho House Health and Welfare Committee on Wednesday advanced a bill critics said would repeal Medicaid expansion. House Bill 138, by Rep. Jordan Redman, R-Coeur d'Alene, requires Idaho to enact 11 Medicaid policy changes or repeal Medicaid expansion — a policy that lets more low-income Idahoans be eligible for the health insurance assistance program. Idaho needs approval from the federal government to implement many of the policy changes — like work requirements, capping expansion enrollment, and kicking people off Medicaid expansion after three years — that Redman's bill would require. If any of those policies aren't in effect by July 2026, the bill would repeal Medicaid expansion, a law passed in 2018 by nearly 61% of Idaho voters. 'Today, you may hear testimony saying that this bill is a sneaky way to repeal Medicaid expansion. And that's simply not the case,' Redman told the committee as the hearing began. 'This bill is taking Medicaid expansion, putting accountability measures in place and cutting waste to make sure that the state is being the best stewards as we can be for taxpayer funds.' But in an analysis of the bill, Idaho Voices for Children found several of those provisions have either never been attempted or approved, even during President Donald Trump's first term. 'To me, this is the bullets in the gun to kind of force them a little bit, right?' Redman told the committee in response to a question. 'I think without that, I do think it could sit on a desk and not have any attention to it.' About 89,300 Idahoans are enrolled in Medicaid expansion, according to December figures from the Idaho Department of Health and Welfare. SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX Last year, the same House committee halted a similar Medicaid expansion reform-or-repeal bill by Redman — after wide public opposition that cast the bill as an attempt to repeal Medicaid expansion with more steps. This year, Redman's bill was also met with wide opposition in public testimony — from doctors, patients on Medicaid and others — that largely focused on the same point. But since last year, the committee's makeup has changed significantly, the Idaho Capital Sun previously reported. And Redman says the federal government — under the Trump administration — is likely to approve the sideboards his bill demands. Dr. Brandon Mickelsen, representing the board of directors for the Idaho Academy of Family Physicians, urged the committee to oppose the bill. Many rural hospitals in Idaho are at risk of closing due to financial reasons, he said. 'These medical costs won't go away if you repeal Medicaid expansion,' Mickelsen said. 'You will create enormous costs for rural hospitals and local communities.' In response to critical questions from committee members about how the bill wouldn't effectively repeal Medicaid expansion, Redman maintained he believed the federal government would likely approve Idaho's requests for sideboards through waivers. And he stressed that the bill is intended to reform — not repeal — Medicaid expansion. Some lawmakers weren't convinced the bill would avoid repeal. 'This is not a reform bill. This will kill Medicaid expansion' said Rep. Marco Erickson, R-Idaho Falls, the committee's vice chair. 'And those rural clinics will be the number one first places to go.' But many of the committee's members who are serving their first year in the Legislature joined Redman and committee Chairman John Vander Woude, R-Nampa, to pass a motion on an 8-7 vote to send the bill to the full House floor, rejecting a motion to hold the bill in committee. Two freshman lawmakers who supported advancing the bill stressed the bill ought to go before the entire Idaho House of Representatives. Noting that the committee members were largely new to serving in the Legislature, Rep. Tanya Burgoyne, R-Pocatello, said, 'I think it would be irresponsible of us not to turn to the institutional knowledge that is here in the body of the House — that has been here that has a lot more insight than us eight freshmen.' The Idaho House 'is responsible for approving the appropriation for this … expansion for Medicaid as a whole,' said Rep. Lucas Cayler, R-Caldwell. Lawmakers on the Idaho House Health and Welfare Committee who voted to advance the bill to the full House floor included: Chairman John Vander Woude, R-Nampa; Rep. Jordan Redman, R-Coeur d'Alene; Rep. Robert Beiswenger, R-Horseshoe Bend; Rep. Lucas Cayler, R-Caldwell; Rep. Tanya Burgoyne, R-Pocatello; Rep. David Leavitt, R-Twin Falls; Rep. Cornel Rasor, R–Sagle; and Rep. Faye Thompson, R-McCall. Lawmakers who opposed advancing the bill included: Rep. Marco Erickson, R-Idaho Falls; Rep. Dori Healey, R-Boise; Rep. Josh Wheeler, R-Ammon; Rep. Ben Fuhriman R-Shelley; Rep. Lori McCann, R-Lewiston; and the committee's two Democrats, Idaho House Minority Leader Ilana Rubel and Rep. Megan Egbert, both from Boise. Three of the five people who spoke in favor of the bill were conservative think tank representatives. That was also similar to last year's hearing. About two dozen people testified against the bill Wednesday. But Egbert said opposition was even wider in written testimony and among people who registered but didn't testify in Wednesday's over two-hour committee hearing. Dr. Kelly McGrath, a family medicine physician who practices in Orofino, told the committee at best the bill would cut off health care access for thousands of Idahoans. At worst the bill would shut down Medicaid expansion, he said. 'The patients I see through Medicaid expansion are often experiencing difficult medical conditions, or just living through challenging financial times. For those patients, health coverage is a literal lifeline,' McGrath testified. McGrath said Idaho Medicaid expansion has let patients access preventive care and screenings that help detect health issues early on, 'when treatments are most effective' and 'less expensive.' CONTACT US 'Recently, I had a patient tell me, 'Without Medicaid, I would be dead,'' McGrath said. 'She was right.' Sandra Rainey, who lives in Boise, told the committee 'it is a blessing' that her 28-year-old daughter — who lives with Rainey and works full-time, earning $14.50 an hour — is on Medicaid, along with her daughter's two kids. Without Medicaid, Rainey said her daughter would go into debt 'every month due to severe asthma issues' along with the cost of medication and physician care. A quarter of Idaho's direct care workforce — in low-paid, demanding jobs that Idaho has a shortage of workers for — rely on Medicaid expansion for insurance, Idaho Council on Developmental Disabilities Executive Director Christine Pisani testified. 'If Medicaid expansion is repealed, 25% of the direct care workforce in Medicaid's home and community based service system would lose their health care coverage due to low wages,' Pisani said. '… This loss would continue to impact the amount of people who work in the direct service field, who are available to support seniors and people with disabilities. We cannot afford to lose any more workers in this field.' Most of the supporters who testified spoke about the need to tamp down rising costs of Idaho Medicaid expansion. The federal government pays 90% of Idaho's Medicaid expansion costs. Report: Federal funds for Idaho Medicaid expansion spurs $1.5 billion in economic output In 2019, before Medicaid expansion, Idaho Medicaid's total budget was almost $2.5 billion, including $1.6 billion in federal dollars and about $880 million in state dollars. For next fiscal year, which starts in July 2025, the Idaho Department of Health and Welfare requested $5.3 billion — including $3.5 billion in federal funds and $1.8 billion in state funds. Idaho Freedom Foundation legislative affairs director Fred Birnbaum called the bill 'a necessity.' 'A gun is to our head. And this bill, if we don't do this now, what will we do? Nothing's been done yet,' Birnbuam said. Speaking on behalf of the Foundation for Government Accountability Action — a Florida-based conservative think tank that worked with Redman on the bill — Paige Terryberry said the bill 'will rescue Idaho's budget, reprioritize the truly needy and restore faith in Idaho's institutions.' Mountain States Policy Center President Chris Cargill said the bill is about adding side rails on Medicaid expansion — not repealing it. 'It's a mistake to assume that just because a waiver hasn't been approved in the past, that it won't be approved in the future,' he testified. 'And what has changed, of course, has been the new Trump administration looking to be more innovative and cutting government waste and getting our fiscal house in order.' Fuhriman, a Republican from Ammon, said he had heard so many different statistics about Idaho Medicaid expansion that he didn't know what to trust. But Fuhriman pointed to economic impacts from Idaho's Medicaid expansion. Estimating that next year, Idaho Medicaid expansion would cost Idaho $130 million, he said that translates to '$65 per capita. But the economic impact of Medicaid … is $750 per capita.' 'I'm a financial planner. That's a pretty good return on investment,' Fuhriman continued. 'We've worked hard to reduce taxes. We've had three different tax bills this session that we're looking at, spearheaded by our speaker, to the tune of nearly $400 million. And we want to say that our budget is out of control because of $130 million being spent on Medicaid — that brings in nearly $47 million in total tax revenue.' Despite rapid population growth, rising costs of living and inflation driving up service costs, an Idaho Fiscal Policy Center report released Tuesday found 'Medicaid costs have grown slower than other parts of the state budget.' Total general fund expenditures in Idaho grew by 39.5% from Idaho's state fiscal years 2019 to 2024, but Medicaid expenditures grew in that time at roughly half that rate — rising 19.6%, according to the report. Idaho Medicaid expansion also saves money across other state programs. In Idaho's fiscal year 2023, state costs for Medicaid expansion were about $73 million, but expansion saved about $78 million that year across other policy areas, like in corrections, drug courts, behavioral health, county indigent funds and state catastrophic health programs. Last week, an economic analysis by University of Idaho professor Steven Peterson found the federal government's extra federal funds for Idaho Medicaid expansion — less than $1 billion this fiscal year — generated $1.5 billion in economic output in Idaho, the Sun previously reported. The report also found those extra federal dollars boosted Idaho's tax revenues by almost $47 million. Since Idaho's Medicaid expansion took effect in 2020, Idaho Hospital Association CEO Brian Whitlock testified that the Legislature has 'given billions in tax relief,' funded education 'at historic levels,' invested in infrastructure at record levels, and stockpiled rainy day funds 'to the brim.' Bonnie Shuster, a Boise resident, also pointed to the Legislature's tax cuts. 'You say we can't afford these funds to keep our people healthy. But then propose even bigger tax cuts that mostly help the wealthy,' she said. 'Please support health care for all of us.' SUPPORT: YOU MAKE OUR WORK POSSIBLE
