More than even a potentially historic gubernatorial election, the push by Idaho voters to pass Medicaid expansion defined the 2018 midterms in the Gem State. So why the hell is the state legislature trying to do everything in its power to curb what its citizenry clearly wants?
With the support of 61 percent of voters—generated largely by grassroots organizers that drove around the state in a green RV—Idahoans decided in November via Proposition 2 that the state should expand its Medicaid program to cover citizens at 138 percent of the federal poverty rate. The constitutional amendment aimed at helping the 62,000 Idahoans that fell in the dreaded Medicaid gap due to constantly rising premiums in the state’s private market and the current income restrictions of the state’s Medicaid policy.
After several months of hemming and hawing about the particulars of what this expansion would look like—and after a lawsuit filed by a libertarian group that was defeated in the state Supreme Court in February—it looked like Idahoans would finally get what they voted for. On Monday, the Senate voted by a margin of 31-3 to approve a Senate Bill 1171, which would budget $2.8 billion for the 2020 Medicaid program—because the federal government covers the majority of the cost, the Senate plan calls for just $9 million to be pulled from state coffers.
In his campaign against Democratic challenger Paulette Jordan, Gov. Brad Little steered clear of ever openly endorsing Prop 2, unlike his predecessor Butch Otter, who voiced support days before the election. While Little said in October it wasn’t his first choice, he consistently said he would enforce the will of the voters. Staying with this line, Little told the Idaho Press Club in February he wouldn’t let the legislature adjourn without establishing funding for Prop 2.
In theory, Monday’s Senate vote should have been good news, followed by a quick passage in the House and a signature by Little. But it’s not quite that simple thanks to a collection of libertarians and conservatives in the House.
CNN reported in early March that the GOP members in the Idaho state House were considering adding a 120-hour per month work requirement—that is, anyone receiving Medicaid, save those with children under 18, would be required to maintain a full-time job in order to receive healthcare. The requirement is harsher than those implemented (and challenged in court) by other states and serves as a pretty good signal of what to expect in the coming weeks.
On Tuesday, Speaker of the House Scott Bedke said at a legislative lunch event that he foresees a long road ahead for any Medicaid expansion bill, according to both the Associated Press and the Idaho Statesman. Bedke’s main critiques concerned the fact that the Democrats in the House have largely stood against work requirements.
Per the Idaho News, Bedke characterized Prop 2 as an “incomplete law,” citing the lack of a funding source as the main obstacle for the conservatives in the legislature who are harshly opposed to raising taxes to offset the costs; Bedke instead said on Tuesday the extra Medicaid funding would likely be pulled from the public school system. While the Idaho legislature typically ends its session around March 25, Bedke warned on Tuesday that they could be there as late as April 5, indicating the conservative faction’s commitment to passing the worst possible form of Medicaid expansion as possible.
House Minority Leader Rep. Mat Erpelding, a Democrat from Boise, pushed back on the notion that Democrats are opposed to amending the law, per the Statesman, saying that the party is in favor of the voluntary work program like the one rolled out in Montana—a 2018 report by Mannatt Health found 78 percent of the unemployed Medicaid enrollees that entered the program were placed in jobs.
So, in one corner, a group of Democrats willing to compromise and cede ground on what should be a cleanly passed bill; in the other, a group of Republicans doing all they can to wield their majority against both the handful of Dems and tens of thousands of Idahoans. Democracy at its finest.