Medicaid questions dominate forum

Nov. 16--What's next for Medicaid expansion -- and how long before people can sign up -- were the main topics of interest during an AARP telephone town hall meeting Thursday with governor-elect Brad Little.

Little, who will take office in January as Idaho's 33rd governor, fielded about a dozen questions during the hourlong meeting.

After noting that he was glad the election is over, and "delighted about the big turnout," Little was asked about the Medicaid expansion initiative, which passed with nearly 61 percent of the vote.

Once the election results are certified next week, he said, the initiative will become law. It directs the Department of Health and Welfare to submit a waiver application to the federal government, asking to expand Medicaid eligibility to anyone who earns less than 138 percent of the federal poverty level.

However, "there are still a lot of unknowns," Little said.

For example, when should the expansion take effect? How will the Legislature pay for it? How will expanded Medicaid interface with the state health insurance exchange and its existing Medicaid program?

"Our goal is to have as smooth a transition as possible, without being (detrimental) to other state programs," Little said.

If Idaho tries to include unique rules within its waiver application -- such as work requirements, means testing or personal responsibility measures -- then it could delay federal approval of the request.

"We'd have to spend a lot more time cajoling our federal partners," Little said.

He agreed with one caller, though, saying a plan that gets approved sooner, rather than later, would be preferable.

Little also said he's committed to continuing Idaho's efforts to create more affordable health insurance options, so there's no disincentive for people to work less in order to stay within the Medicaid income eligibility limits.

"There needs to be an effective pathway and incentive for families to raise their income and prosper and not be stuck in Medicaid," he said.

Other topics discussed during the town hall meeting included education, forest health and the state sales tax on groceries.

Little said he supports repealing the grocery tax and expects the issue to come up during the 2019 legislative session. The timing of any repeal, though, may depend on the projected cost of Medicaid expansion, as well as on growth in state revenue collections.

"I made a commitment (to repeal) the grocery tax, but that was based on us having the revenues to maintain our commitment to education," he said.

Little said he also wants to ramp up the tree-thinning and forest health activities under the federal Good Neighbor authority, to help reduce the risk of catastrophic wildfires in the state.

During the gubernatorial campaign, Little issued detailed proposals for improving education affordability, jobs and the economy. He indicated that he'll have more to say on many of these topics during his inaugural address in January.

Spence may be contacted at bspence@lmtribune.com or (208) 791-9168.

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