WWAMI bill advances to House

BOISE — After limited testimony, the House Education Committee on Wednesday approved a bill to cut 10 seats from Idaho’s long-standing medical education partnership with the University of Washington and shift to a new regional medical school.

House Bill 368, which eliminates at least 10 seats from WWAMI — which stands for Washington, Wyoming, Alaska, Montana, Idaho — will now go to the full House for consideration. The bill would require 10 seats a year be added at another medical school, likely the University of Utah, each year until it reaches a total of 30.

It also would direct the State Board of Education to develop a plan for medical education in Idaho.

The committee voted 8-5 to send the bill to the floor after about 45 minutes of testimony from three people.

Bill sponsor Rep. Dustin Manwaring, R-Pocatello, introduced HB 368 as an alternative to his previous bill, HB 176, which would have completely withdrawn Idaho from WWAMI. The bill was met with strong resistance from physicians connected to the medical education program.

“When I came to Boise this year, I did not have on my checklist to frustrate Idaho doctors,” Manwaring said.

He noted that Idaho is ranked last among states in doctors per capita. He said the bill was an effort to diversify medical education partnerships.

A few committee members questioned the reduction of seats in WWAMI if the goal is to increase the number of seats for Idaho medical students. Rep. Dan Garner, R-Clifton, also asked why the bill was moving ahead with actions prior to the recommendation that would be created by the State Board of Education.

Manwaring responded that he felt it was important that withdrawing from WWAMI should remain on the table as the state considers changes.

“WWAMI does not have, and should not have, an advantage in the end, over what we’re going to invest our state dollars in,” Manwaring said. “So investing outside of WWAMI needs to be equally considered with the WWAMI investment.”

The state spends around $7.8 million to support Idaho students in the WWAMI program. Under the program, the students spend their first two years of classroom instruction at the University of Idaho and their last two years of clinical rotation at sites in Idaho or other states in the program.

Although there were several people signed up to testify, only one representative each from the University of Utah, WWAMI, and the State Board of Education spoke at the roughly 45-minute hearing.

Dr. Benjamin Chan, University of Utah School of Medicine associate dean of admissions and of Idaho Affairs, spoke in favor of the bill and that the school was “eager and excited to help the state of Idaho and our region.”

The University of Utah currently has 10 seats reserved for Idaho medical students. Those students do their first two years at the school’s main campus in Salt Lake City and family medicine clinical rotations in Idaho, spending four to six weeks in the Gem State through those rotations, Chan said.

Chan anticipates that in a new program, the 30 new Idaho students would only do the end of their training in Salt Lake for rotations in specialty areas that may not be available in Idaho.

Staff from the University of Idaho previously said it had already signed a memorandum of understanding with the Utah school to look into creating a new partnership. The school has met with its accrediting body, the Liaison Committee on Medical Education (LCME), about the possible creation of a “regional medical campus” that could include Idaho.

Rep. Jack Nelsen, R-Jerome, asked about the curriculum and how schools balance state laws and the need to prepare students to pass the national board examinations to become licensed physicians.

“My idea is every medical student, at the end of the trail, has to pass the same national boards,” Nelsen said. “I think some people have a really, really biased opinion one way or another on different states and their laws, and looking at it from simply a training institution — your graduates and WWAMI, anybody have to take, in my view, exactly the same test.”

Idaho has a near-total felony ban on performing abortions, and has told the University of Washington that none of its funds can go toward abortion training for Idaho medical students; that amendment was not signed by the UW president until hours after HB 176 came up for a hearing.

Utah had a trigger law that would have implemented a near-total ban after the U.S. Supreme Court overturned Roe v. Wade on June 24, 2022, but its state Supreme Court has blocked the law from going into effect. Abortions in the state are legal for up to 18 weeks.

Chan said he feels confident the school can work with the Idaho State Board of Education and accreditor to “come up with a curriculum that not only will help students be the best doctors they can, will be very Idaho-centric, with the values that this committee as well as the Legislature espouse.”

Rep. Monica Church, D-Boise, asked whether the Utah school would be making cuts or raising tuition in anticipation of a bill passed by the neighboring state’s legislature cutting $60 million from higher education. Under that bill, which is expected to be signed by Utah Gov. Spencer Cox, the University of Utah would see a cut by $19.6 million, the Salt Lake Tribune reported.

Chan responded that while he wasn’t exactly sure of the particulars, he heard most of the cuts were planned for programs on the main campus, and that health sciences has remained “unscathed.”

Dr. Mary Barinaga, a family doctor and assistant dean in the Idaho WWAMI program, said that her job is to find physicians to host students for their clinical rotations.

“This is the absolute biggest challenge that we face to growing medical education in Idaho, whether that’s done by WWAMI or by University of Utah or another medical school,” Barinaga said.

She said that the program hasn’t “always listened carefully and responded quickly to everyone’s concerns.” She highlighted that when the Legislature asked the program to expand Idaho seats in a 2022 piece of legislation, the state did not provide any added funding for that.

She said that work was still being done.

“We are asking to be part of the solution,” Barinaga said. “To do this, we ask that the program, the WWAMI, stays stable so we can maintain the clinical training sites in Idaho. We have the infrastructure already.”

State Board of Education Executive Director Josh Whitworth said that the board was prepared to create a plan. The board has already taken steps, in February voting to form a medical education committee to address “ongoing issues and questions” regarding WWAMI, according to a Feb. 20 press release.

Committee Chairperson Rep. Doug Pickett, R-Oakley, stopped testimony around 8:45 a.m., after an 8 a.m. meeting start time. He cited conflicting meetings and the 10 a.m. House floor session.

There were 29 total people signed up to testify, and 26 of them were opposed to the bill, according to the sign-in sheet.

Rep. Chris Mathias, D-Boise, made a motion to send the bill to what’s known as “general orders,” which is where House members may suggest amendments to be voted on by the whole chamber.

Mathias said he had concerns about the bill’s wording, which would require that the Idaho seats in WWAMI be reduced by “at least” 10 students by the 2027-28 academic year. His motion died in a 5-8 vote.

Rep. Mark Sauter, R-Coeur d’Alene, made a motion to hold the bill in committee and asked that a new bill be brought back that looked to expand Idaho medical school seats without reducing any in the WWAMI program.

“The heartburn I have with all of this is that we’re not set up yet,” Sauter said. “From Dr. Chan in Utah, I heard ‘hopeful,’ and ‘very possible,’ I just feel like this is premature to drop WWAMI to drop any seats.”

Sauter’s bill also died in a 5-8 vote.

The committee passed the bill 8-5 to send to the House floor with the recommendation that it pass.

Guido covers Idaho politics for the Lewiston Tribune, Moscow-Pullman Daily News and Idaho Press of Nampa. She may be contacted at lguido@idahopress.com and can be found on Twitter @EyeOnBoiseGuido.