Several Democratic lawmakers from Boise came to the Capitol Friday morning to testify against a proposal to require Medicaid recipients to get a referral from their primary care doctor to access family planning services.
“It only hurts women’s health care, with really no benefit on the other side whatsoever,” said Rep. Ilana Rubel.
Several people said they’re not sure the proposal is legal, suggesting that the federal government won’t approve it or, if it is approved, it will lead to a lawsuit the state will lose.
“What this means is hundreds of thousands of dollars in attorneys’ fees, increased cost to the system and a lack of patient choice, all of which are a consequence of this waiver,” said Rep. John Gannon. “The waiver discriminates against one class of people, women, and that’s why there will be a lawsuit. And that’s why there will be a lot of attorney’s fees. And whenever the case is lost, the state of Idaho will be looking at paying attorney’s fees.”
The waiver in question, which lawmakers approved earlier this year as part of a bill requesting several other waivers to make changes to Medicaid expansion, would require most Medicaid recipients to receive a referral from their primary care doctor to get outside family planning services.
The waiver’s intent, the Department of Health and Welfare said in a news release last week, is to see if monitoring and knowing about external family planning services can help achieve better care coordination and improved health outcomes.
The waiver itself says costs would be the same with or without the waiver. However, some people who testified said it could end up costing more by requiring women to see two doctors, delay access to sometimes time-sensitive care and create a hurdle women with private insurance don’t have to worry about.
Six people testified at Friday’s hearing, all opposing the proposal. As well as Gannon, Rubel, Rep. Melissa Wintrow and Sen. Grant Burgoyne, Lori Burrelle and Tracy Olson, representing the National Organization for Women’s Southwest Idaho chapter and Reclaim Idaho, respectively, testified against it.
“The politicians are clearly trying to limit women’s choices when it comes to family health care,” Olson said. Reclaim Idaho is the group responsible for getting Medicaid expansion on the ballot, and since its passage, it has been lobbying against making any changes to expansion.
Public comment on another controversial proposed waiver, to add work requirements for Medicaid expansion recipients, closes on Sunday. The Centers for Medicare and Medicaid Services already responded to one of the state’s waiver requests to let some people get insurance through the Your Health Idaho state exchange instead of expanded Medicaid, saying the state’s application was incomplete and the proposal would increase federal spending. Gov. Brad Little and Republican legislative leaders have said they plan to change and resubmit this proposal.
Friday’s public hearing was the last of two on the proposed family planning waiver. Seven people spoke at a hearing on Monday, also all against the waiver, said DHW spokeswoman Niki Forbing-Orr.
Public comment is still being accepted by email or mail through Oct. 12, after which the waiver will be submitted to CMS. People can email comments to 1115_FamPlan@dhw.idaho.gov or mail them to Clay Lord, Medicaid Program Policy Analyst, Division of Medicaid, P.O. Box 83720; Boise, ID 83720-0009.