Revoking Medicaid coverage: More war on the poor

One has to wonder what some Idaho legislators have against low-income Idahoans. Why do they want to harm the working poor by revoking their Medicaid coverage for no apparent benefit to the state?

In 2018, by a wide majority, Idahoans voted to expand Medicaid to cover lower-income people who earned too much to qualify for standard Medicaid but too little to afford private health insurance. This expansion made medical treatment accessible to more than 100,000 Idahoans who previously were financially locked out of health care. It has relieved countless Idahoans of unnecessary suffering and very probably saved lives. But now, House Bill 419, sponsored by Republican Rep. Jordan Redman, is structured to furtively repeal this lifeline for low-income Idahoans. HB 419 conditions the continuation of Medicaid expansion on the state obtaining federal waiver, by July 1, 2025, to allow a work requirement for adult recipients. It would also impose an enrollment cap of 50,000, which is roughly half the number of current enrollees.

As supporters of this bill undoubtedly know, Idaho already has an application pending for a similar work-requirement waiver. That application, filed in September 2019, has been pending without approval for the intervening four years. Moreover, work requirement waivers in several states have been struck down by courts. Therefore, the chance of a new waiver application gaining approval from federal authorities before July 1, 2025, is virtually nil. So if HB 419 is enacted, the nearly inevitable effect will be a full repeal of Medicaid expansion, stripping medical coverage away from approximately 100,000 low-income Idahoans, including those who unquestionably are unable to work. Imposition of a reasonable and flexible work requirement for able-bodied adults to receive Medicaid may be fair; automatic termination of Medicaid expansion for all recipients if the federal authorities won’t bend to the will of the Idaho Legislature is not.

Importantly, this repeal will not save state money and therefore will be of no benefit to the state or its taxpayers. According to both the Idaho Department of Health and Welfare and a private study, Medicaid expansion has actually saved tens of millions in state funds through enhanced federal funding and the replacement of previous, more expensive state-funded health programs, including behavioral health and medical care for the indigent and the incarcerated. Repeal of Medicaid expansion will therefore increase the burden on Idaho taxpayers.

Given that repealing Medicaid expansion will not reduce state expenditures, we can only wonder why any legislator wants to take health care away from low-income Idahoans. Whose interests are these legislators serving? It’s not their constituents.