Chairman Vander Woude: Oppose H. 464 | Council For Citizens Against Government Waste

Chairman Vander Woude: Oppose H. 464

State Action

February 21, 2018

The Honorable John Vander Woude
Majority Caucus Chairman
Idaho House of Representatives
P.O. Box 83720
Boise, ID  83720-0038

Dear Chairman Vander Woude,

It is our understanding that a vote on H. 464, which would provide the authority for the director of the Idaho Department of Insurance to apply to the secretary of the Department of Health and Human Services for a State Innovation 1332 waiver under the Patient Protection and Affordable Care Act (ACA), better known as Obamacare, and a Medicaid 1115 waiver, has been put on hold.

The Council for Citizens Against Government Waste (CCAGW) is particularly concerned with the 1115 waiver, which would expand Medicaid by creating a new “Complex Medical Needs Program.”  According to the January 22, 2018, Idaho Department of Health and Welfare draft proposal, the goal of the 1115 waiver “is to allow Idahoans with Complex Medical Needs (CMN), who have household incomes up to 400% of the Federal Poverty Level (FPL), to access comprehensive coverage under the Medicaid program.”  While this is a supposed attempt to “stabilize” the ACA exchange, it is Medicaid expansion by any other measure.  On behalf of the 11,606 CCAGW members and supporters in the state of Idaho, I ask that you oppose H. 464.

Encouraging more Idahoans to participate in Medicaid promotes the progressive agenda to push all Americans into government-run healthcare.  Furthermore, the state is unwisely sending some of its most vulnerable citizens into a program that is known for its limited access to physicians, especially specialists.  In a November 11, 2017, speech before the National Association of Medicaid Directors, Centers for Medicaid and Medicare Administrator Seema Verma noted that “despite our growth in spending, and in regulations, more than 1/3 of doctors won’t even see Medicaid patients.”  Not getting access to the care these types of patients require will drive up costs, not lower them.

In April 2017, the governor signed into law SB 1150, which changed existing law by allowing individuals with high risk medical conditions and their dependents, who are enrolled in individual health benefit plans, to be reinsured through the Idaho Individual High Risk Reinsurance pool.  The purpose of the legislation was to stabilize the individual insurance market, and it became effective on July 1, 2017.  According to the bill’s fiscal impact note, there is no direct fiscal impact to the General Fund or any other state fund or expenditure.  CCAGW believes this policy should be allowed to fully take effect or be modified before helping to bail out the insurers by expanding Medicaid.

In March 2017, the governor also signed into law HB 101, which would encourage non-U.S. licensed reinsurers, which are licensed and domiciled in qualified jurisdictions, to come into the state by reducing their collateral requirements.  This will help make reinsurance more affordable and stabilize all insurance policies.  The law became effective on July 1, 2017.

Lawmakers may wish to consider Alaska’s 1332 waiver, which was approved in July 2017.  The purpose of the waiver was to stabilize the individual market.  It did not require additional federal funding and was projected to reduce premiums by 20 percent for 2018.

The waiver allowed the claims of patients with at least one of 33 pre-determined high-cost conditions to be removed from the individual market risk pool and paid instead through the Alaska Reinsurance Program (ARP), thus lowering the premiums for other consumers.  The state would receive pass-through funding based on the amount of premium tax credits that would have been provided absent the waiver.

The ARP has paid off.  According to a December 2017 Heritage Foundation study that analyzed CMS data, premiums for a 40-year-old in a bronze plan dropped 25 percent.  An August 2, 2017 Modern Healthcare article reported that insurance rates in the individual market would decrease on average by 22 percent.  The Alaska waiver would seem to be a better approach to lowering premiums than expanding Medicaid.

Meanwhile, we urge you to join CCAGW and tens of millions of Americans to continue to keep pressure on our elected representatives in Washington, D.C. to repeal Obamacare.


Thomas Schatz




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