Idaho lawmakers listen to Medicaid expansion proposal as supporters begin uphill push

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BOISE, Idaho — Medicaid expansion supporters began their uphill journey Thursday in attempting to win over Idaho's Republican-controlled Statehouse where most lawmakers consider the idea politically toxic.

Idaho Department of Health and Welfare Director Dick Armstrong tells the House and Senate Health and Welfare Committees that the state could save more than $173 million over the next 10 years by loosening its Medicaid eligibility.

"Some people say you can't trust the feds, well in 50 years that really hasn't happened but then again the past 50 years doesn't mean much for the future," Armstrong said. "Bottom line, the savings to Idaho are forever."

Medicaid expansion is one of the options provided under the Affordable Care Act. States have the option to expand their coverage with the federal government fronting 100 percent of the costs for 10 years and dropping to 90 percent afterward.

Armstrong outlined a proposed plan backed by a governor's work group that would allow individuals below 100 percent of the poverty line to qualify for Medicaid coverage. Adults earning 100 percent to 138 percent of the poverty line may purchase private insurance on Idaho's health insurance marketplace using federal dollars.

It also includes an opt-out clause in case the federal government alters its funding in the future.

Armstrong said doing so would provide coverage to roughly 78,000 of Idaho's poorest adults.

Republican lawmakers have been hesitant to discuss Medicaid expansion —shutting down almost all previous proposals — but recognize the state's indigent care system is broken. However, Gov. C.L. "Butch" Otter requested in his annual State of the State address that he wants legislators to hear the available options regarding Medicaid expansion.

Yet any sort of Medicaid expansion faces a challenge among Republican lawmakers who view the federal government's funding involvement as further contributing to federal deficit spending.

"It's true the federal government hasn't stopped funding for the past 50 years, but the federal government has never been $18 trillion in debt before," said Republican Sen. Marv Hagedorn of Meridian.

Armstrong's Thursday presentations did not follow with a bill introduction. Instead, the director hinted that a proposed bill was in the works but he did not know when or if it would make it before a legislative committee.

Republican Sen. Sheryl Nuxoll of Cottonwood asked if the state should really expand Medicaid or if it should focus on getting people off of federal assistance.

Armstrong agreed that he would prefer to have Idahoans off of assistance but said that would require the state having more better-paying jobs.

After spending nearly an hour discussing the presentation, Senate House and Welfare Chairman Lee Heider told lawmakers that the information was helpful but not too worry too much about the details.

"I wouldn't worry about it too much unless it moves forward and someone drafts legislation," he said.

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