Gov. Little shares ‘concerns’ over Republican-led push to end Idaho’s Medicaid expansion

A bill that would likely slash health insurance coverage for tens of thousands of lower-income Idahoans through the state’s Medicaid expansion program sparked heated debate before it passed the House by a narrow margin last week and was sent to the Senate.

In the days following, its sponsor, Rep. Jordan Redman, R-Coeur d’Alene, fielded questions and concerns from other lawmakers — not to mention phone calls, “nasty emails” and “death threats” from residents, he told a House committee Tuesday. (Redman also spoke at a Saturday town hall in Coeur d’Alene that turned volatile after some attendees expressed concern over the possible repeal of Medicaid expansion and other bills, the Coeur d’Alene Press reported.)

Adding to the turmoil, Gov. Brad Little expressed his own reservations about cutting the program at a Tuesday morning press conference. The two-term Republican governor said he was “all about cost control,” but also said it was important to remember that Medicaid expansion “was passed overwhelmingly by the public” just over six years ago.

Later the same morning, Redman introduced what another lawmaker called a “compromise bill” to address concerns with House Bill 138, which would cut off Medicaid expansion unless a set of 11 lofty conditions are met — several of which would require federal approval that historically has not been forthcoming. (A separate bill this session, sponsored by Rep. Josh Tanner, R-Eagle, would repeal Medicaid expansion outright, but has yet to advance.)

Redman’s new bill walked back some of the conditions, including time limits on how long Idahoans could receive Medicaid expansion funds and a cap on the number of people enrolled in the program, among other changes, he said Tuesday. His initial bill would have limited program recipients to three years of coverage.

Outside experts and even some Republican lawmakers had said meeting all 11 conditions required to maintain the program had very little chance of happening, the Idaho Statesman previously reported.

Redman’s new bill also removed a requirement in the previous bill to “trigger” a repeal of the expansion if the 11 conditions were not met, he said Tuesday.

Rep. Marco Erickson, R-Idaho Falls, expressed appreciation at the Tuesday committee meeting for Redman’s new bill, which members voted unanimously to introduce for a future public hearing.

Citizen-led Medicare expansion passed with 60% approval

The Affordable Care Act, passed in 2010 under the Obama administration, required states to expand Medicaid coverage to continue receiving federal funding. But the U.S. Supreme Court struck down that requirement in 2012, leaving it to individual states to decide whether to broaden the list of qualified recipients.

The GOP-dominated Idaho Legislature chose not to expand offerings to residents in the so-called coverage gap — those who earned too much to qualify for standard Medicaid, but not enough for private insurance discounts. The number of Idahoans included in this gap is about 90,000, according to the Idaho Department of Health and Welfare.

This led Idaho residents to bring forth a successful ballot measure in 2018, and Medicaid expansion has been in place in Idaho since then. The program offers coverage to a larger number of those residents. Backed by then-Gov. Butch Otter, the citizen-led effort passed with more than 60% approval, the Statesman previously reported. Little was his Republican predecessor’s lieutenant governor at the time.

Republicans have for years taken issue with the cost of the state’s Medicaid expansion after voters approved it through the initiative process. The cost of the largely federally funded program “is not sustainable,” Rep. Wendy Horman, R-Idaho Falls, said on the House floor last week. Rep. John Vander Woude, R-Nampa, said last month that its expected costs to the state far exceeded what lawmakers expected: from $32 million in projected costs in 2018 to $110 million in fiscal year 2026.

Some lawmakers have expressed unease that the state may risk being saddled with greater costs if the federal government under the Trump administration curtails funding for the program. Cutting Medicaid spending is central to the budget bill that U.S. House Republicans may soon bring to a vote as part of an effort to pay for President Trump’s tax cuts, The New York Times reported Tuesday.

Little declined to say Tuesday whether he would sign Redman’s initial bill, but acknowledged he had “significant issues” with the legislation.

“I’ve read enough of it to know I’ve got concerns,” he said.

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