Dick Armstrong, who served as director of the Idaho Department of Health & Welfare under GOP Govs. Butch Otter and Jim Risch, has sent out a guest opinion to Idaho newspapers urging Gov. Brad Little to veto SB 1204aa, the much-amended Medicaid "sideboards" and work requirements bill. Here is Armstrong's piece:
By Dick Armstrong
Last Friday, Governor Little vetoed SB 1159, legislation that would have radically transformed Idaho’s ballot initiative requirements. Governor Little issued the veto because he believes “The bills invite legal challenges that likely will result in the Idaho initiative process being determined by the liberal Ninth Circuit Court of Appeals.”
In the wake of this news, the Legislature passed the heavily amended Senate Bill 1204. This harmful and costly attempt to change Medicaid expansion as passed by Idaho voters was amended to include several onerous provisions to legislation that was originally supported by the Senate and healthcare advocates alike. The most damaging provision is a punitive work requirement that would remove from the program Medicaid-eligible Idahoans who are out of work or become entangled in bureaucratic red tape.
The action of the Legislature is surprisingly tone-deaf. The bill flies in the face of the voters’ approval of a clean Medicaid expansion ballot initiative with 61% of the vote. It snubs more than 12 hours of public testimony overwhelmingly opposing harmful barriers to coverage, including work-reporting requirements. It also ignores a late-February poll that found that 74% of Idahoans feel the Legislature should implement the law as it was passed by the voters, while only 17% say the law should be changed.
Furthermore, the Legislature discarded Governor Little’s instructions within his State of the State address: “For months, I made it clear I would honor the will of the people. I intend to work with you to implement Medicaid expansion using an Idaho approach. We need spring in our safety net so that there are multiple pathways for the gap population to move off Medicaid and onto private coverage.”
Most significantly, the Legislature even ignored the ruling of a federal judge who struck down Medicaid work-reporting requirements in Kentucky and Arkansas just one week earlier. In his decision, the judge wrote that because work-reporting requirements violate the central tenet of the Medicaid program (to furnish medical care to low-income individuals), taking away coverage does not advance the objectives of the program and is, therefore, illegal.
Legislators themselves even recognized that work-reporting requirements are likely to be overruled in court, adding a backup punitive copay measure “just in case.” The measure only kicks in once the work-reporting requirements are deemed illegal.
Idaho will face the same legal risks that Governor Little feared in his SB 1159 veto message, unless he rejects S 1204aaHaasS. The Governor vetoed SB 1159 because he didn’t want Idaho taxpayers to foot the bill for an expensive legal battle that we are sure to lose. Little would be wise to apply this same logic to the amended SB 1204 and learn from the mistakes of other states, or low-income Idahoans and taxpayers alike are sure to pay the price. Because the Legislature has failed to properly represent their constituents’ wishes regarding Medicaid expansion, Idahoans are now counting on Governor Little to stand up for the majority of Idahoans, avoid wasting taxpayer dollars and entangling Idaho in costly litigation, and veto SB 1204.
Dick Armstrong was appointed by Governor Risch as Director of the Idaho Department of Health & Welfare in 2006 and continued to hold that position under Governor Otter. He retired in 2017.