Medicaid expansion is officially on the chopping block at the Idaho legislature

Idaho lawmakers are beginning the work to repeal the state’s voter-approved Medicaid expansion program.

The House Health and Welfare Committee introduced the bill Friday morning, which would end health coverage for more than 85,000 Idahoans.

Those who qualify under Medicaid expansion earn too much to enroll in traditional Medicaid and too little to qualify for a federal health insurance subsidy through the state exchange.

It’s expected to cost the state nearly $98 million under Gov. Brad Little’s proposed budget for the upcoming fiscal year. That’s 10% of the state’s share for all Medicaid programs.

“We’re on a trajectory that I just don’t think that we can afford to continue and I do think we need to take a closer look on how this is funded, what the programs are,” said Rep. John Vander Woude (R-Nampa), who introduced the bill.

The federal government currently covers 90% of the bill for Medicaid expansion, something Vander Woude and other critics of the program worry will be reduced in future years.

House Minority Leader Ilana Rubel (D-Boise) pushed back during the bill’s introductory hearing. She said cutting Medicaid expansion entirely would actually cost Idaho more in the long run.

“There have been huge savings throughout the system in corrections and behavioral health. Certainly in terms of all those funds we had to [pay for] before to ensure we don’t lose all our rural hospitals,” Rubel said.

Previously, counties and the state partnered to cover health care costs for indigent residents beyond an $11,000 deductible each year known as the Catastrophic Health Care Cost Program, or CAT fund.

Residents needed to apply for the funds and be approved before receiving coverage.

Vander Woude acknowledged his bill would not reinstate the CAT fund, though something similar could be proposed in the future.

“I wasn’t crazy about the CAT fund when we had it and I’m still not crazy about it now. I believe that we may have to develop some programs later that will incur some costs if this moves forward,” he said.

Rubel and her counterpart leader in the Senate, Melissa Wintrow (D-Boise), issued a statement after the hearing blasting the bill as “in service to extremist ideology…”

“[Medicaid expansion] has saved countless lives and has protected thousands of Idaho families from financial ruin and health disaster. Our duty as legislators is to protect the will and wellbeing of the voters,” they wrote.

The bill could receive a public hearing in the House Health and Welfare Committee, which Vander Woude chairs, as early as next week.

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