Idaho Senate votes against Medicaid expansion amendment

March 17--The Idaho Senate on Thursday voted against an amendment that would have expanded Medicaid.

The proposed amendment was to a bill sponsored by Sen. Marv Hagedorn, R-Meridian, a $10 million plan to provide primary care coverage to about 15,000 chronically ill uninsured people, many of whom would fall in the "Medicaid gap" group where they don't make enough to qualify for tax credits for subsidized insurance on the exchange but also don't qualify for traditional Medicaid.

Sen. Maryanne Jordan, D-Boise, who offered the amendment, said Medicaid expansion would still make sense even if the Republican proposal in Congress to repeal and replace the Affordable Care Act passes. That bill allows Medicaid expansion to continue at the current rate of federal funding until 2020.

Sen. Jim Rice, R-Caldwell, argued her proposal would result in people who currently have insurance through the state exchange being thrown off, citing an estimate that 50,000 people who are on the exchange now could fall into that group if Medicaid were to be expanded to people making up to 133 percent of the poverty level.

"That's half the enrollees on the exchange," he said. "That would make our exchange insolvent. It would destroy it. And this at a time when it is not clear what our Congress will do."

Sen. Jamie Ward-Engelking, D-Boise, said it would be a better use of the money in Hagedorn's bill, which would come from the state's Millennium Fund, to expand Medicaid, given the federal 90-10 match ratio.

"That would be $100 million we could use to help this gap population," she said.

The Senate killed Jordan's amendment on what sounded like a party-line voice vote, then proceeded to approve another amendment to the bill, brought by Sen. Steve Thayn, R-Emmett, that would create a pilot program within Hagedorn's program to provide managed care and other services 250 people. The language is the same as in a larger proposal Thayn introduced earlier in the session.

The bill could come to a vote before the full Senate early next week, after which it would head to the House. Its chances there look bleak at the moment -- Assistant Majority Leader Brent Crane, R-Nampa, said Thursday he doesn't expect the House to pass anything on health care, and with lawmakers hoping to adjourn on March 24 there isn't much time to change people's minds.

"I don't think we're going to move anything," he said.

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