Moreover, even if additional information is forthcoming, the agency said, the waiver likely "would not be approvable" because it isn't deficit neutral.
The move does not affect any proposed Medicaid work restrictions, which will be addressed in a separate waiver application.
Nevertheless, Thursday's decision was a setback for Republican lawmakers, who earlier this year imposed a series of restrictions and conditions on the Medicaid expansion initiative that voters approved last fall.
Besides the work restrictions, lawmakers wanted people earning 100 percent to 138 percent of the federal poverty level to have the option to buy subsidized private health insurance, rather than automatically be enrolled in Medicaid. They directed state officials to apply for a waiver allowing individuals in that income category to qualify for federal tax credits, which would lower the cost of their monthly premiums.
However, in the letter to
Specifically, they said the application incorrectly assumed that, if the waiver wasn't granted, people in the 100 percent to 138 percent category would not be eligible for Medicaid. The waiver also failed to demonstrate that the insurance premium tax credits were a cheaper option than just enrolling people in Medicaid.
"Any ... waiver application that would increase the federal deficit cannot be approved by the federal government," the letter stated.
In a joint news release, Gov.
"We are disappointed and surprised by the assessment from CMS about our waiver application, after the amount of work and coordination
The news release said the 100-138 waiver "remains a high priority for
"It's important to give Idahoans the choice to stay on private coverage rather than forcing them onto public assistance," it said. "The state is already taking steps to submit the additional information required by CMS, so that our application can be fully considered on its merits."
Lawmakers knew the 100-138 proposal was a long shot to begin with, since no waiver of that type has previously been approved. Still, their objections to Medicaid and other public entitlement programs is such that they felt the effort had to be made.
A separate effort to impose a 20-hour-per-week work requirement on the expanded Medicaid program has yet to be presented to the federal government for approval.
Public hearings on the proposed work requirements will take place in
More information on the various Medicaid expansion waivers can be found at medicaidexpansion.idaho.gov/.
Spence may be contacted at [email protected] or (208) 791-9168.
How to participate
Comments can be emailed to [email protected], or mailed to:
Medicaid Program Policy Analyst
P.O. Box 83720
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