Idaho - Oppose Medicaid Expansion By Another Name | Council For Citizens Against Government Waste

Idaho - Oppose Medicaid Expansion By Another Name

State Action

March 20, 2018

Idaho House of Representatives
700 West Jefferson Street
Boise, ID  83720-0038

Dear Representative,

It is our understanding that you will soon consider HB 464, which would allow the Department of Health and Welfare to apply to the Secretary of Health and Human Services (HHS) for a Medicaid 1115 waiver.  While this is a supposed attempt to “stabilize” the Patient Protection and Affordable Care Act (ACA) exchange in Idaho, it is Medicaid expansion by any other measure and a bailout for insurers.  On behalf of the more than 11,621 members and supporters of the Council for Citizens Against Government Waste (CCAGW) in the state of Idaho, I ask that you oppose HB 464.

The 1115 waiver, if permitted by HHS, 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.”  CCAGW understands the frustration you may have with Congress in not repealing and replacing ACA, or Obamacare, which has driven up premiums in the individual market across the country.  However, the last thing a fiscally responsible state like Idaho should do is to adopt the policies of senators like Bernie Sanders (I-Vt.) and Elizabeth Warren (D-Mass.) and expand a government-run healthcare system, such as Medicaid, to stabilize the individual insurance market.

Encouraging more Idahoans to participate in Medicaid promotes the progressive agenda to push all Americans into government-run healthcare.  Furthermore, the state would be 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.”

In April 2017, Governor Otter 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 any consideration is given to bailing out the insurers by expanding Medicaid.

Also, in March 2017, the governor 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 the example of Alaska’s 1332 waiver, which was approved in July 2017.  The purpose of the waiver was to stabilize the individual market.  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 waiver allowed the state to use what would have been federal premium tax credits and cost-sharing reductions to fund the reinsurance program.

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 by 25 percent.  An August 2, 2017 Modern Healthcare article reported that insurance rates in the individual market would decrease by an average of 22 percent.  The Alaska waiver would seem to be a better approach to lowering premiums than expanding Medicaid. 

Please oppose HB 464.  We also 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.

Sincerely,

Thomas A. Schatz

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