EDITORIAL: Tell federal regulators to reject Idaho’s work requirements for Medicaid expansion

Idaho Statesman (Boise)

Sep. 15--Federal regulators should shoot down, deny, decline and otherwise reject the Idaho Legislature's wish to add a "work requirement" to Medicaid expansion.

Idaho's voters didn't vote for a work requirement when they passed, with 61 percent support, Medicaid expansion for those who fall in the coverage gap, the tens of thousands of people who make too much money to qualify for Idaho Medicaid health insurance but too little to qualify for subsidies on the private health insurance exchange.

Voters voted to get those people onto Medicaid in January.

But legislators, in a bill signed by Gov. Brad Little, tacked on a work requirement. Under that requirement, most low-income Idahoans would have to file paperwork to prove they are employed, studying or otherwise occupied to get Medicaid.

One of our biggest reasons for opposing this filing requirement is the expensive level of bureaucracy this will add to state government. Not only will it add to the paperwork that public paper pushers will have to push around, it also adds to the burden for already-burdened, low-income, sometimes rural workers who are just trying to get health insurance so they can treat illness, stay healthy and -- go to work.

When the state's own estimates suggest that as many as 16,000 Idahoans who would otherwise get health insurance under Medicaid expansion would fail to qualify under work requirement paperwork, it's hard to see the work requirement as anything other than a malicious attempt to get people off the rolls.

Nampa Republican Rep. John Vander Woude, who pushed for the requirement during the legislative session, said he believes lawmakers "made enough exemptions in the work requirements, and it's not to try to hurt people." But that illustrates how legislators are working the problem backwards.

Legislators, like Vander Woude, have an image of a lazy bumpkin who can now stay at home, play video games all day, not work and still get Medicaid health insurance. And, the argument goes, because the lazy bumpkin now has health insurance through Medicaid expansion, he now has no motivation to get off his couch and go get a good job that provides health insurance. Lazy bumpkins, of course, won't be able to claim any exemptions and will be eliminated. So if the state can just tweak the number and type of exemptions, they can finally get down to the point that not a single lazy bumpkin gets a dime.

Of course, we concede that there are folks out there like that.

But how many lazy bumpkins do we have? Do we have 16,000? Because that's what the state estimates will be ineligible under work requirements.

No, the state's work requirement prefers to punish some (likely thousands of) qualified recipients all so that they don't pay one red cent for some undeserving slouches.

Rather, they want to set up an expensive, paperwork-dripping bureaucracy to make sure we don't get any lazy bumpkins slipping through the back door -- even if it means hurting deserving Idahoans who either can't or don't file the paperwork, for whatever reason.

If that weren't enough, we urge the federal regulators to shoot down the requirements to save Idaho taxpayers the expense of legal fees.

Similar work requirements in Kentucky and Arkansas were struck down by a federal judge in March, and there's no reasonable indication that Idaho's work requirements would somehow escape the same fate. So if we plow ahead with this plan, not only would we have the added cost of administering the paperwork, legislators should add a little bit extra in the state's legal fund to defend work requirements in court.

The Idaho Department of Health and Welfare is still accepting public comments on the work requirements through Sept. 22 via email to [email protected] -- or by mail to Cindy Brock, Medicaid Program Policy Analyst, Division of Medicaid, P.O. Box 83720, Boise.

The state plans to submit the waiver application to the Centers for Medicare and Medicaid Services after that. The centers may then decide to approve or reject the waiver.

We encourage our readers to comment in opposition to the work requirement. Hopefully someone along the line will listen.

Statesman editorials are the unsigned opinion expressing the consensus of the Idaho Statesman's editorial board.

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