The federal government threw a monkey wrench into the Idaho Legislature’s attempt to hornswaggle many residents out of participation in Medicaid expansion. The move was an excellent opening salvo in favor of those who would benefit from expansion.
Medicaid expansion, as passed by more than 60 percent of the Idaho voters in 2018, allows an estimated 90,000 Idahoans access to health care through the successful and popular state-federal partnership.
Many states took advantage of Affordable Care Act rules that allowed them to broaden Medicaid coverage with the feds covering 90 percent of the cost. The only “catch” was states must abide by rules set forth by the feds who were shelling out most of the cost for the program.
Idaho legislators balked at extending the existing Medicaid partnership to residents who were in the so-called insurance gap: those making too much to qualify for Medicaid and not enough to afford insurance offered by the state exchange.
This left thousands of folks without proper health care, and counties and the state with increasing indigent care costs. And they remained in that limbo for nearly a decade until a citizen’s initiative made it through the rigorous process of qualifying for the ballot.
Proposition 2 posed the simple question: Should the state expand Medicaid coverage for those in the gap?
Faced with the measure’s success, the Legislature in January set to work trying to dismantle or make additions and weaken its scope.
One of the sidebars to the initiative was a waiver request to allow possible recipients to choose between Medicaid and subsidized private health insurance.
After months of information gathering, hearings and public input, the waiver was submitted to the Centers for Medicaid and Medicare Services. On Aug. 29, CMS responded with a resounding rejection saying more information was needed for evaluation. The agency also indicated sending additional paperwork would do little good because the waiver was not “deficit neutral.” In other words, the waiver would cost more if approved.
You can imagine the righteous indignation displayed by Idaho officials who worked so hard and long to adulterate Prop. 2. They did not disappoint.
In a joint communiqué, Gov. Brad Little, House Speaker Scott Bedke and Senate President Pro Tem Brent Hill state: “We are disappointed and surprised by the assessment from CMS about our waiver application, after the amount of work and coordination Idaho spent (on the application). Simply put, CMS pulled the rug out from under us.”
The mental image of those august Republicans spilling about aside, CMS did the correct thing. It has yet to grant such a waiver and is not likely to.
Truth be told, the rug is being pulled out from under the 90,000 Idahoans whose health care is being stymied by lawmakers at every turn.
Medicaid is an excellent program and has been since 1965. Millions have participated in the program and benefited from regular health care.
A healthy citizenry is crucial to the social and economic well-being of any society. So it makes us wonder why Idaho officials are so dead set against the concept.
— Murf Raquet, for the editorial board