Expanded Medicaid in Idaho promoted in physician’s bills

BOISE – A physician in the Idaho state Senate introduced two bills to expand Medicaid in the state.

“I’ve been working for years to get Republican support and can’t, so what the heck,” Sen. Dan Schmidt, D-Moscow, said Friday. “At least it’s written down. People can look at the numbers, look at the proposals. They’ll be public record. They can compare.”

Most Idaho legislation requires a committee vote even to be introduced, but individual lawmakers can propose personal bills without committee votes in the early weeks of each year’s legislative session. Schmidt’s two bills were filed on the final day of that period.

Gov. Butch Otter convened several task forces in recent years that all recommended expanding Medicaid – an option for states under the federal Affordable Care Act. Such expansion would serve the estimated 78,000 people in Idaho who fall into a coverage gap, earning too much to qualify for Medicaid and too little to qualify for subsidized health insurance under the state exchange.

But state lawmakers who want no part of Obamacare have been unwilling to consider the move.

“The governor’s bill is going to be out there and it’ll have numbers, and people can look at that,” said Schmidt, referring to Otter’s proposal for a state-funded $30 million “Primary Care Access Program,” which would provide some limited primary and preventive care to the uninsured.

Instead of costing the state $30 million, Medicaid expansion would save state taxpayers millions, because the federal government would cover nearly all its costs and the state would no longer need to spend millions on a catastrophic care program for people with unpaid medical bills.

In a guest opinion sent out to Idaho newspapers this week, Otter wrote that his Primary Care Access Program, or something like it, “is all that we can reasonably hope to achieve right now in the context of Idaho’s political environment.”

But Schmidt said he disagrees.

“I think the majority party is trying to portray that there aren’t some choices, and that’s how the governor has framed this – that this is his only choice.”

Schmidt’s two bills include one that would enact the “Healthy Idaho Plan,” a proposal from Otter’s latest task force that would expand Medicaid for those who make up to 100 percent of the federal poverty level, then use federal Medicaid expansion funds to purchase private insurance through the state exchange for those who make up to 138 percent of the poverty level.

Last year, 54,000 Idahoans applied for coverage through the exchange but were turned away because their incomes were too low to qualify.

Schmidt’s other bill would follow the recommendation of Otter’s first task force, expanding Medicaid to the full extent allowed by law – to adults earning up to 138 percent of the poverty level.

“That will save Idahoans the most money,” Schmidt said. “It’ll have the most impact on the general fund.”

Schmidt said the latest estimates show the Healthy Idaho Plan would save Idaho $28.4 million next year. The full-expansion option would save $44.3 million.

Schmidt said this is the first time in his six years in the Senate that he’s filed a personal bill.

“When I first got elected, my goal was to work with the majority party, and talk about policy issues and try to foster a healthy discussion for moving Idaho forward,” he said.

Schmidt has made his mark on the Legislature’s joint budget committee by working closely with some of the panel’s most conservative GOP members on compromise funding proposals for the state’s health and human services programs.

“I’m not giving up,” he said. “I still believe people can, and do, even in this body, change their minds pretty quickly.”