Medicaid expansion is set to launch in January 2020, this comes after the Idaho Department of Health and Welfare (IDHW) saw 43,000 of the 91,000 eligible Idaho residents apply for coverage.
The expansion will provide coverage to Idaho residents between the ages of 19 and 64 who make up to a maximum of 138% of the federal poverty level. Individuals who earn up to $17,200 or $35,500 for a family of four will be eligible.
The voter initiative was passed in November of 2018 with 61% of the vote but was met with some restrictions in the Idaho legislature earlier this year. The waivers, expansions on the types of settings in which people can receive comprehensive long-term care, included work restrictions requiring eligible residents to work at least twenty hours a week. A second waiver required referals for family planning services such as birth control, abortions and pregnancy care.
The U.S. Department of Health and Human Services for Medicaid and Medicare services will still have to rule on these and any additional waivers. This process can take months and will likely happen after the coverage date of January 1.
IDHW is still encouraging Idaho residents to sign up for coverage. If any restrictions are passed, applicants will be notified.
Many of those who are eligible for Medicaid are independent students at Boise State who work part-time jobs or do not work at all. Jacob Kendra, a junior media arts major, believes it is time that the state closes the gap on those residents who cannot afford regular insurance coverage.
“It gives students like me who are making less money an option to get some form of assistance,” Kendra said. “I’m on a temporary health care plan right now that is meant to be used as a supplement to the primary insurance, it only covers the basics, leaving me underinsured and still paying a premium every month. I don’t work or have a job so the Medicaid initiative would benefit me.”
Committee chair Rep. Megan Blanksma has concerns with those who fall in the gap that allows them to qualify for Medicaid but are currently paying for their insurance through the Affordable Care Act.
“What people are forgetting here is that Medicaid is public assistance, which means although 90% of doctors take Medicaid, they can limit how many Medicaid patients they take and even limit the days they take Medicaid patients,” Blanksma said.
Currently, under 18,000 Idaho residents are covered through the state health insurance exchange who will now be auto-enrolled in Medicaid based on the writing of the expansion. An additional waiver has been filed to allow those individuals to stay enrolled in their health care plans but has not been approved yet.
“We have put a detriment on these folks who will get thrown off their insurance, some without their knowledge,” Blanksma said.
Rep. Mat Erpelding does not feel the provisions are needed and believes the restrictions and requirements put in place will be rejected.
“The least expensive way and the most fair way is for the state to pay for it out of the general fund,” Erpelding said. “Savings at the state level should be applied to pay for Medicaid.”
The expansion would add about 90,000 people to the Medicaid program costing about $400 million with the federal government paying 90%, leaving Idaho to pay for $40 million.
$10 million was set aside earlier this year to pay for six months of the program. State lawmakers are looking at various methods to fund the expansion and are hoping to rely on counties for help. County indigent funds, or catastrophic funds which typically help pay for medical bills of county residents are also being considered. Lawmakers are even looking to tap into the anti-smoking millennium fund.
There has been no consensus and the committee plans to meet to look over options before the legislature reconvenes in January.