BOISE, Idaho — Idaho Speaker of the House Scott Bedke says he doesn't have enough votes to pass either a basic Medicaid expansion bill or a Medicaid expansion bill that includes work requirements, and it could be weeks before a compromise is found.
Bedke, a Republican from Oakley, made the remarks Tuesday at a Legislative Leadership Luncheon event hosted by the Idaho Press Club.
Voters authorized Medicaid expansion in November through an initiative called Proposition 2 after years of inaction by the Legislature. The expansion will provide access to health care for Idaho residents who are too poor to get health insurance on the state exchange, but earn too much to qualify for the state's current Medicaid program.
The legislature's budget-setting committee has approved a budget that would cover the state's initial cost for expansion through offsets by savings in other state agency budgets, and on Monday the Senate approved the funding bill. But Medicaid expansion remains a contentious issue on the House side of the Legislature, with various proposals circulated that would require recipients to work unless they meet certain exemptions, would automatically end the program if federal subsidy amounts changed or would require lawmakers to review the program in a few years to see if more changes are needed.
Bedke said he believed the House Health and Welfare Committee will work to get a bill to the full House for a vote, even if that means they send it to the floor without a recommendation on which way lawmakers should vote. But he wouldn't say whether he would push to pass a bill that wasn't supported by most in the Republican Party, even if he had enough votes.
That's a question for April 5, Bedke said, listing a date a week later than the normal end-of-March target for wrapping up the legislative session.
The remark drew a rebuke from House Minority Leader Rep. Mat Erpelding of Boise.
"My friend the speaker just said, 'we intend to marginalize the minority until April 5,' " Erpelding said. He said if given the options the Democrats would pass a bill today that included a voluntary work training program, similar to one in Montana that has been hailed as a success. A report issued last year by Manatt Health found that 78 percent of Medicaid expansion enrollees in Montana who were unemployed when they started coverage and went through the program found jobs. That's about 200 people, according to the Montana Department of Labor and Industry.
Some mandatory work requirements in other states, such as Arkansas, have been challenged in court, and a court has overturned Kentucky's work requirement over concerns that large numbers of people would lose coverage, according to a recent report by the Center for Health Policy Research at George Washington University.
Bedke, in turn, criticized the Democrats for what he said was putting a "stake in the ground" too early in the process because the Democrats said at the outset they wouldn't support work requirements. He said that essentially stopped negotiations from proceeding.
"Not having any provisions and sideboards is a stake in the ground that is not palatable to the majority party at this point," he said.