BOISE — After a hearing that was a marked contrast to all previous hearings held this session on the matter, the Senate Health & Welfare Committee on Thursday voted 5-4 in favor of SB 1204, Sen. Fred Martin’s compromise Medicaid expansion “sideboards” bill. Unlike previous proposals, this bill drew strongly supportive testimony from a range of speakers, along with smiles, laughter and applause.
Several of the senators who voted “no” said they favored a pending motion that also would have passed the bill to the full Senate, but without recommendation. Sen. Mary Souza, R-Coeur d’Alene, said she thought that would avoid “fuss” from the House, since that’s how the House sent out its much more controversial “sideboards” bill from committee. However, she was outvoted.
“Today is the beginning of March Madness for college basketball fans across the country, but for those of us who have been involved in this issue, the madness has gone on for a long time,” Idaho Hospital Association President Brian Whitlock told the committee. “Thank you for bringing some sanity.” The bill, he said, “implements the will of the people with the lightest touch of government possible.”
Jim Baugh of Disability Rights Idaho said, “I think what’s new here, at least compared to the House bills, is the voluntary vocational assistance and job promotion,” which he said “embodies a very excellent response to the governor’s call for putting some spring in the safety net. So the notion is we have a safety net, and we want to stop people before they hit the ground, we don’t want them to be caught in the safety net. We want to have something that helps them spring back up.”
“I think that’s the right solution to promoting employment and work,” he said.
Baugh also praised the bill’s inclusion of a task force to study the impact of Medicaid expansion on Idaho’s existing county-state indigent care and catastrophic health care program, which he called “very, very important.”
Lupe Wissel, state director of AARP Idaho, said, “Your bill addresses those issues that I’ve been talking about the last couple of days. For folks between 50 and 64, it is harder for those folks to get back into employment, but this bill really helps those people who need help. It gives some opportunity to get some training, to enhance their skills, to be competitive with the workforce. So I just want to say thank you very much.”
Sam Sandmire, a prominent activist for Medicaid expansion, told the senators, “SB 1204 is a compromise that I can live with.”
Among groups strongly endorsing the bill at Thursday’s hearing were the Idaho College of Emergency Physicians, the Idaho Rural Health Association, the Idaho Association of Counties, the Idaho Council on Developmental Disabilities, Idaho Medical Association, American Association of University Women, and more. The only opposition came from Fred Birnbaum, lobbyist and vice president for the Idaho Freedom Foundation.
Rebecca Schroeder, executive director of Reclaim Idaho, the group that spearheaded the Proposition 2 campaign for Medicaid expansion, said, “Reclaim Idaho recognizes that this compromise bill will not construct barriers to coverage, will not create a secondary gap, and will not waste millions of dollars. … This, senators, is a piece of legislation that we can live with.”
In addition to the voluntary work-promotion program, the bill includes what’s been called the “IMD” waiver to allow Medicaid to cover certain mental health services (IMD stands for “Institutions for Mental Diseases”); and provisions saying lawmakers must consider ending expansion if the federal funding share dropped below the current 90 percent; and that lawmakers could consider ending it if there were other changes to Medicaid expansion brought about by Congress or courts. It also requires patients to be questioned about substance abuse and referred to services, along with calling for the task force.
Martin, R-Boise, said, “My intent on this bill is to have a compromise bill that will be able to proceed forward through this committee, hopefully through the Senate, and then see what happens after that. I realize we don’t do this in a vacuum. … Across the rotunda, they’re debating maybe something different from this. We’ll see what transpires.”
Previous hearings on the more far-reaching House proposals to change the voter-approved Medicaid expansion initiative, including adding mandatory work requirements, have drawn hundreds of vocal opponents.
Prior to Thursday’s public testimony, in which 18 people spoke, Sen. Abby Lee, R-Fruitland, moved to send Martin’s Senate bill to the full Senate with no recommendation. Sen. Lee Heider, R-Twin Falls, seconded the motion. But after hearing the testimony, Heider said, “In light of the fact that all of the testimony today has been in favor except for the Freedom Foundation, I think that’s a tremendous recommendation.” He made a substitute motion to send the bill to the full Senate with a recommendation that it “do pass,” and Sen. Maryanne Jordan, D-Boise, seconded that motion.
The four “no” votes came from Souza, Lee, and Sens. Mark Harris, R-Soda Springs, and Regina Bayer, R-Boise. Voting “yes” were Sens. Heider, Jordan, Martin, David Nelson, D-Moscow, and Van Burtenshaw, R-Terreton.