Medicaid Expansion rally

Backers of a ballot initiative supporting Medicaid expansion form a human chain in the Capitol rotunda to deliver boxes of verified petitions to the Idaho Secretary of State’s office after a rally on the Capitol steps in downtown Boise, Friday, July 6, 2018.

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Open enrollment deadlines are approaching for two state health insurance programs.

The state’s Medicare program’s open enrollment period ends Monday.

Once enrolled, insurance policies for those who gain access to Idaho’s government-provided insurance begin Jan. 1. State insurance specialists are available at 800-247-4422 to answer questions about eligibility and policies.

“Medicare can be confusing,” state insurance department head Dean Cameron said in a news release this week. “However, Idaho consumers have options for plans that best fit their medical needs. I strongly encourage consumers to seek guidance from our (specialists) and a licensed agent.”

Also ending soon is open enrollment for Idaho’s state health insurance exchange, Your Health Idaho, through which some people can access subsidized insurance based on their income. That ends Dec. 16.

During open enrollment periods, anyone can apply and gain access to these public policies. For the state exchange, if someone loses their existing health insurance policy or has another significant change, such as having a child, they may be eligible to enroll in an insurance plan through the exchange outside of the open enrollment period.

Next year also is the second that a broader range of low-income Idahoans can access Medicaid, a policy brought about by a volunteer-led initiative that led to 60.6% of Idaho voters voting in 2018 to expand Medicaid. That’s close to the typical vote margins Republican candidates have received in statewide elections in recent years.

Medicaid has historically been limited to providing insurance for people with disabilities, children and pregnant women, and people with extremely low incomes. Until this past January, a gap in income eligibility for Medicaid and the state-subsidized insurance left tens of thousands of low-income Idahoans in the lurch — not able to access any public assistance for insurance.

Now, a single Idahoan without dependents who earns up to $17,616 a year can qualify for Medicaid. They can enroll at any time. So far, over 94,000 Idahoans are covered through Medicaid, according to the state health department. During the coronavirus pandemic, demand has outpaced expectations, in part, because many Idahoans lost jobs that helped provide insurance, the Idaho Press reported last month.

Medicaid expansion is largely funded by the federal government. The Affordable Care Act passed by Congress in 2010 incentivized states to expand Medicaid eligibility caps from 100% to 138% of the federal poverty limit by offering to pay for most of the policy. Idaho was one of over a dozen states that refused.

Idahoans who made between 100% and 400% of the federal poverty limit could get insurance on the state exchange, with most of the cost covered by federal income tax credits in most cases. This left some low-income earners in a gap: They didn’t make enough to qualify for subsidized insurance on the exchange but they couldn’t sign up for Medicaid since Idaho hadn’t expanded Medicaid coverage to the able-bodied poor, which is what the Affordable Care Act had originally envisioned all states would do.

State lawmakers refused for six years to address the gap population. Volunteers led by the grassroots organization Reclaim Idaho, along with some paid organizers, in 2018 gathered tens of thousands of signatures from registered Idaho voters to get expansion on the ballot as a legal policy mandate.

When voters approved Medicaid expansion, it was the first policy that Idaho voters had directly approved in over a decade. (Several policies had been rejected or repealed by initiatives in that time, according to the Secretary of State’s office.)

Post Register reporter Nathan Brown contributed.

Reporter Kyle Pfannenstiel can be reached at 208-542-6754. Follow him on Twitter: @pfannyyy. He is a corps member with Report for America, a national service program that places journalists into local newsrooms.

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