BOISE — At the state’s first public hearing Tuesday on a proposed waiver request to the federal government to add work reporting requirements to voter-approved Medicaid expansion, testimony was overwhelmingly against the plan, with nearly 10 times as many people opposing it as supporting it.
“The proposed work requirements are counterintuitive, as access to health care is a pathway to work, not vice versa,” said Diana Braskich of Coeur d’Alene.
During the public hearing at the Idaho Capitol, 30 people offered testimony. Twenty-seven of them opposed the plan; three supported it.
“The waiver will limit needed health care services both for those people out of work, and for those people who are meeting requirements but failing to prove it to the state,” said Don Kemper of Boise. “Many would meet the requirement but find it too difficult.”
Sam Sandmire of Reclaim Idaho said the waiver is “not a work requirement but rather a paperwork penalty. When a similar restriction was imposed in other states, we saw disastrous results. In Arkansas, 18,000 lost their coverage … just because they failed to fill out the forms correctly.”
She also noted that a federal judge already has overturned similar requirements in three states. “There is no reason to believe they will do any differently in Idaho’s case,” she said.
Prior to the hearing, the Close the Gap coalition, a broad coalition of health care providers, business groups, advocates and more across the state, held a press conference to speak out against the waiver, which would require recipients of Idaho’s expanded Medicaid program to certify every month that they worked at least 20 hours a week, or completed other requirements including volunteering or participating in education for the same number of hours.
“Mandating employment will not allow a sick person to heal,” Dr. Lesleigh Box with Saint Alphonsus said at the press conference. “Making a sick person well will allow them to work.”
“In Idaho’s proposal, missing a single monthly report or having insufficient hours in just one month will mean loss of coverage,” said Lauren Necochea, director of Idaho Voices for Children. “This is a one strike, you’re out rule.”
The three who spoke in favor of the proposal included Rep. John Vander Woude, R-Nampa, the lead sponsor of the legislation. “I don’t think it’s overburdensome,” Vander Woude said. “I think we’ve made enough exemptions. … These people are already working. So I don’t know what the issue is.”
Machele Hamilton of Nampa, chairwoman of the Canyon County Republican Central Committee, said, “I just don’t understand why if I have to work to provide insurance for low-income people, why can’t they work to receive it?”
Rep. Melissa Wintrow, D-Boise, said, “I firmly stand in opposition to the waiver because the purpose of Medicaid is to provide, as we’ve heard over and over again, health care for low-income individuals. It’s not to create systems to track people’s work hours and create an undue burden.” She said the proposal amounts to requiring “working people to report their hours as if they’re on probation.”
“It’s not really about work. It’s about reporting,” Wintrow said.
Five state lawmakers testified on the waiver; among them, only Vander Woude supported it.
Among those testifying against the proposed waiver were doctors and other health care professionals; citizens who have suffered health problems; parents; business owners; people currently living in Idaho’s health coverage gap; and advocates.
Brenda Foster said, “Please do not go forward with this burden to Medicaid expansion in Idaho. It’s a costly bureaucratic burden for our government and our taxpayers. … For me it’s heartbreaking to feel that the burden of proof would be shoved off onto our most vulnerable citizens. So I hope we can implement a clean Medicaid expansion, the one people voted for. I think it would be the most efficient and the most effective.”
Idaho voters backed Medicaid expansion in November with 61% in favor. In this year’s session the state Legislature, which had not taken action on the matter for six years, attached a series of restrictions to it, with the work reporting requirements among the most controversial. A series of waivers from federal rules is required to go forward with the restrictions; one, to give a portion of those who otherwise would qualify for expanded Medicaid the option of instead buying subsidized private insurance through the state insurance exchange, already has been rejected by the Trump administration. Administration officials said the proposal failed because it wasn’t cost-neutral.
Tuesday’s public hearing was the first of two; the second will be Friday from 1-3 p.m. in the East Conference Room, Joe R. Williams Building, 700 W. State St. People who can’t attend in person may participate by phone, by calling 877-820-7831, #301388. The state Department of Health and Welfare also is accepting written public comments, including by email, through Sept. 22; they may be sent to firstname.lastname@example.org, or mailed to Cindy Brock, Medicaid Program Policy Analyst, Division of Medicaid, P.O. Box 83720, Boise ID 83720-0009.
Adam Jacobs of Rexburg, who called in to Tuesday’s hearing, said he’s a married father of three and soon to be four. “My family has lived within the Medicaid gap for some time,” he said. “I have a full-time job as well as two other jobs that I work to try to make ends meet. But health care insurance is extremely expensive, even for hard-working Americans like myself.”
He said he voted for Medicaid expansion to close the state’s coverage gap. But restrictions, he said, “I believe are hurtful to Idahoans by creating more hurdles to jump and more loopholes to have to find to go through. It’s only preventing people from getting access to health care.”
Jacobs said the restrictions appear to him to be political efforts only. “Hear the voice of Idaho people,” he said, “that we want expansion — no gimmicks.”