- Associated Press - Wednesday, April 3, 2019

BOISE, Idaho (AP) - A House committee on Wednesday voted to send a compromise Idaho Medicaid expansion bill with mandatory work requirements to the full House for amending.

The Health and Welfare Committee sent to the House the bill that has already passed the Senate where it was also amended.

The legislation is an attempt to reach a compromise that can clear both chambers and get Republican Gov. Brad Little’s signature.

It’s not clear how the House might amend the bill.

“I think we’re going to look at where the House is willing to go,” said Republican Majority Caucus Chair Megan Blanksma, a member of the committee, after the vote. “And there’s going to be the thought on what the vote was on the Senate side and what they’re willing to work with.”

The Senate version passed 20-15.

The legislation currently has mandatory work and other requirements but does not eliminate Medicaid for people if they do not fulfill the work requirements. A House bill that revoked Medicaid for able-bodied people after 60 days if they did not work was killed by a Senate committee last month.

Blanksma said she did not know if that requirement might be added back in with amendments in the House.

Voters authorized Medicaid expansion in an initiative in November with 61% of the vote after years of inaction by the Legislature.

The expansion will provide access to preventative health care services for an estimated 91,000 low-income residents. The federal government would cover 90% of the estimated $400 million cost.

The Senate previously passed an appropriations bill paying for Medicaid expansion as approved by voters with no work requirements. Little has included $20 million for the expansion in his budget.

However, the House has refused to vote on the appropriations bill because a majority of members appear to want work and other requirements for Medicaid recipients. Blanksma said there are also other concerns, including the state getting stuck paying more if the federal government reduces its 90% portion of the Medicaid cost.

The Senate bill requires able-bodied Medicaid recipients who fail to meet the work requirements to make copayments when seeking medical services, but it does not kick them off Medicaid. The number of people who might fall under the work requirement is estimated at 12,000.

The bill would also seek a waiver from the federal government to allow people earning 100 to 138 percent of the federal poverty level to stay on the state’s health insurance exchange rather than go on Medicaid.

Backers of the legislation have said the work requirement and the insurance waiver along with other requirements could save the state several million dollars.

Democratic Rep. Ilana Rubel questioned those claims and distributed information from the state’s legislative accounting agency saying the cost would be more than $4 million to begin and then administer the requirements.

“We’re going to be chasing people in dire poverty to make them pay $4, maybe sometimes $10 as a copay, and we’re going to spend $4.1 million to do it,” she said in arguing to kill the bill. “It crosses the line into outright insanity.”

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