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Lawmakers Debate Medicaid Expansion Details as Session Winds Down


Wednesday, March 20, 2019   

BOISE, Idaho - With the legislative session drawing to an end, Idaho lawmakers still are working out how to implement voter-backed Medicaid expansion.

A number of bills have been introduced, many of which are attempts to add work requirements. The latest effort, House Bill 277 by Rep. John Vander Woude, R-Nampa, would require Medicaid enrollees to work 20 hours a week.

Not only would that limit who could get coverage, said Lauren Necochea, director of Idaho Voices for Children and a member of Close the Gap Idaho, but it also would cost the state more.

"These new requirements come with heavy administrative costs, and that's not what voters intended," she said. "They wanted that funding to go to health care, not to administration. And what's really exciting about Medicaid expansion is that it will create significant savings in our crisis-care systems, in our behavioral-health services."

Necochea said the preventive-care aspects of having health coverage would bring the cost down. Fiscal estimates for a previous version of this bill, which also had a 20-hour-a-week work minimum, put administrative costs at $1.5 million a year. Supporters of work requirements are convinced they'd keep overall costs for the program down. A hearing is expected on the revised bill today.

Necochea said the benefits of expansion are maximized if no one is left out, which is one reason some businesses got behind the measure.

"The businesses who supported Medicaid expansion were really excited to see health-care costs go down, because we had fewer uninsured people in our communities," she said, "and that's a benefit that is at risk if we start to take some people out of Medicaid expansion."

The legislative session is scheduled to end on March 29. However, Gov. Brad Little said he won't allow lawmakers to go home until they pass funding for expansion. Sixty-one percent of Idaho voters approved of Medicaid expansion in November.

The text of HB 277 is online at

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