Rep. Jordan Redman, R-Coeur d’Alene, on the Idaho House floor on March 25, 2024. (Kyle Pfannenstiel/Idaho Capital Sun)
A bill meant to contain Medicaid costs in Idaho is headed to the House floor for a vote after the House Health and Welfare Committee voted to advance it on Tuesday.
House Bill 345 would create work and volunteer requirements for able-bodied Idahoans enrolled in Medicaid, and let Idahoans eligible for Medicaid expansion access tax credits to purchase insurance on Idaho’s health care exchange.
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It would require the Idaho Department of Health and Welfare seek waivers from the federal government, a move that some legislators have been skeptical of, the Idaho Capital Sun previously reported. In 2019, Idaho failed to receive federal approval — then by the Trump administration — for Medicaid work requirements and an exchange tax credit option, which are similar to the new bill’s provisions, the Idaho Capital Sun previously reported.
Bill sponsor, Rep. Jordan Redman, R-Coeur d’Alene, said the bill would provide immediate savings to the state and long term sustainability and accountability measures.
After more than an hour of testimony and two failed motions to hold the bill in the committee, the committee voted along party lines to move the bill to the House floor with a recommendation that it pass. The Idaho House will vote on the bill at a later date.
“It’s none of my intention to not provide the services to those who need it and those who are eligible, but it is my intention to make sure that we can kind of control the cost,” said bill cosponsor and committee chairman Rep. John Vander Woude, R-Nampa.
Most bill opponents spoke in opposition to House Bill 345
Legislators on the committee thanked Redman for drafting the legislation in a way that comprised the need to cut down on Medicaid costs without entirely repealing Medicaid expansion. However, most of those who testified opposed the legislation, including health care providers and representatives from nonprofit groups who mostly criticized the bill’s work requirements, citing concerns it would implement more bureaucratic hurdles for low-income Idahoans seeking health care.
Jennifer Johnson, was the first to testify to the committee. As a business owner and single parent with two children with serious medical conditions, she said her family relies on Medicaid expansion for care and prescriptions.
“While I understand the goal of reducing Medicaid costs, this bill does the opposite by adding unnecessary expenses and red tape,” Johnson said. “Adding work requirements is unnecessary. Those who are participating in Medicaid through expansion are people like me who are working one or more jobs, volunteering in the community and raising families, but doing so at low incomes.”
Like Johnson, Dr. Melanie Edwards, a physical therapist from Idaho Falls, opposed the bill. Edwards said the bill would not control costs. She said bureaucratic barriers, such as job reporting requirements, would cause Idahoans to lose their Medicaid, ultimately reducing access to preventive care. She also said she is concerned about the term “able-bodied” in the bill.
“I think of people in the early 60s, such as a retired farmer with a bad back from a lifetime of hard work and no local job or volunteer opportunities that he could do, or a man who has severe mental illness such that he’s unable to work,” Edwards said. “Most of these people have not been classified as disabled, and so are regarded as able-bodied. These situations are not rare outliers in Idaho. The work or volunteer requirement would strip away their care.”
Chris Cargill, the president of the Mountain States Policy Center, spoke in favor of the legislation.
“This program was specifically designed for the most vulnerable, the working poor, parents with children and the disabled,” Cargill said. “Medicaid was never intended to provide health insurance for more than 20% of the population. As you all know, the cost of Medicaid coverage for the state is skyrocketing, and unless you act, you could very well lose financial control of this program.”
“If the federal government reduced Medicaid expansion dollars tomorrow, would Idaho be ready?” Cargill said to the committee.
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