Idaho Republicans have ‘grave concerns’ about Medicaid expansion. What they decided

BOISE (Idaho Statesman) – Lawmakers tasked with recommending whether to continue with the state’s Medicaid expansion say they support funding the voter-approved benefits.

But the Republican legislators expressed concern about rising costs and directed Medicaid administrators to find ways to cut spending.

Idaho voters in 2018 approved Medicaid expansion, extending the subsidized health benefits to Idahoans with household incomes at 138% of the federal poverty level. Lawmakers set a Jan. 31, 2023, deadline by which the House and Senate Health and Welfare committees would reconsider whether to continue funding expanded benefits.

In the meantime, Medicaid expansion costs have more than doubled, from about $400 million to $1 billion, though most of the costs will be covered by the federal government.

Total estimated costs for the state will be $88.3 million. The Department of Health and Welfare, which oversees the program, anticipates another 3% increase in costs next fiscal year.

While the committees supported continuing the benefits, they also recommended the program face reevaluation in two years.

“The committee has grave concerns about the cost sustainability of the current program, but they do realize that the outcomes of stopping it at this point would not be in the best interest of Idahoans,” Sen. Julie VanOrden, R-Pingree, who chairs the Senate Health and Welfare Committee, wrote in a letter to Senate President Pro Tem Chuck Winder, R-Boise.

Similarly, the House Health and Welfare Committee chairman, Rep. John Vander Woude, R-Nampa, wrote in a letter to House Speaker Mike Moyle, R-Star, that his committee “has serious concerns regarding the unsustainability” of current spending.

INELIGIBLE MEDICAID ENROLLEES TO SOON LOSE COVERAGE

The committees recommended a few ways to cut costs, including swiftly removing ineligible Medicaid enrollees who will soon lose federal protection under a public health emergency. The federal rule bars states from removing Medicaid enrollees amid the COVID-19 pandemic. It’s scheduled to end April 1.

About 67,000 ineligible Medicaid expansion enrollees likely are protected by the expiring rule, Health and Welfare officials recently told lawmakers. The department is preparing to launch a six-month process to notify those people and remove their benefits.

The House Health and Welfare Committee urged the department to complete the process by July 1, while the Senate committee recommended completion “as quickly and efficiently as possible.”

The committees also directed the department to seek waivers from the federal government that would give the state more flexibility to regulate Medicaid. One waiver would allow the state to require that Medicaid participants are employed.

The chairs said their committees will reevaluate Medicaid expansion in 2025.

Ultimately, the Legislature’s budget-setting Joint Finance-Appropriations Committee will decide whether to continue funding Medicaid expansion in the near term. Co-chair Rep. Wendy Horman, R-Idaho Falls, last month called the cost hikes an “urgent problem” on “an unsustainable trajectory.”

Niki Forbing-Orr, spokesperson for Health and Welfare, told the Statesman in an email that the department will continue to communicate new national guidance on eligibility so the state can remain in compliance with the federal government.