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Idaho legislative lookahead: Medicaid expansion review

Idaho lawmakers are set to review Medicaid expansion in the Gem State five years after it was passed by voters.

BOISE, Idaho — Lawmakers hit the ground running after the pomp and circumstance of the State of the State Address at the statehouse Monday. Gov. Brad Little set the tone with his priorities: education, infrastructure and property tax, to name a few.

Legislators are ready to debate something Gov. Little did not mention in his address: Medicaid expansion and funding. Medicaid expansion was passed by Idaho voters in 2018, but it is now up for review, per law. 

In the Medicaid eligibility expansion law a final section reads:

“No later than January 31 in the 2023 legislative session, the Senate and House of Representatives health and welfare committees shall review all fiscal, health, and other impacts of Medicaid eligibility expansion pursuant to this section and shall make a recommendation to the legislature as to whether such expansion should remain in effect.”

Speaker of the House Mike Moyle, a Republican from Star, expressed concerns in December heading into the 2023 session about the cost of the program while speaking on KTVB’s Viewpoint:

“You're going to have some issues that people aren't talking about to Medicaid," Moyle said. "For example, Medicaid expansion is up for review this year. Medicaid surpassed public education school funding last year. We've got to get our hands around that and so I'm hoping we can do some things there to stop that from breaking the state, basically."

Setting up the debate for the year, Moyle said the review process at the statehouse will be "top to bottom."

“I wish I knew, I don't know yet. But I do know that we get a look at it from top to bottom and I do think that, that was put in the law for a good reason, because it sounded really good when it got here and it hasn't really performed on what we were sold,” Moyle said.  “Ultimately, we've got to get the costs under control, because if they keep skyrocketing like they are, we're all in trouble. I would hate to have to start cutting budgets and raising taxes for Medicaid expansion at the expense of our schools and everything else that the government provides for the citizens.”

Idaho Democrats responded minutes later, as Senate Minority Leader Melissa Wintrow shared her thoughts in support of Medicaid:

“Medicaid has been a wonderful investment in our state and it has kept thousands of people healthy and on health insurance," Wintrow said. "Thank God we had Medicaid expansion when we did, especially during this pandemic, and we will not want to strip anyone of their health care, especially in this economy. So, I hope to see that we renew that Medicaid. It has been a huge investment in our state. It has benefited all our population and we need, as we know, healthcare, which is the foundation of any healthy community."

Luke Mayville is the Co-Founder of Reclaim Idaho, the organization that pushed for and succeeded in getting Medicaid expansion approved by voters in 2018. While Medicaid costs have gone up since the program started, Mayville said it is important to look at the funding share between Idaho and the federal government.

“This is one of the most fiscally-responsible programs imaginable. When Idaho legislators keep saying that the budget is out of control, they are misleading the public, because the truth is, 90% of the program is covered by new federal dollars coming into the state," Mayville said. "These legislators will mention that the program is costing $58 million, but they won't mention that that's only about 1% of the state budget. They also always neglect to mention the savings that the program is generating."

Still, some lawmakers argue growing costs could compromise spending in other areas, regardless of federal funding. Lawmakers will take the battle up in the coming days and weeks.

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