The Legislature’s 2019 session has reached its final weeks, and a House committee has scheduled a major hearing for this morning on proposed legislation that would add restrictions to Medicaid expansion.
The House Health and Welfare Committee is scheduled to take up the proposal, from Rep. John Vander Woude, R-Nampa, at 8 a.m. today, March 8.
Last fall, Idaho voters passed a ballot measure expanding Medicaid with 60.6 percent support.
If passed by the Legislature, HB 249 would add work requirements to Medicaid recipients similar to those imposed on recipients of the Supplemental Nutrition Assistance Program (commonly referred to as food stamps). To receive SNAP benefits in Idaho, recipients must work or participate in a training or employment program, unless they qualify for an exemption. Vander Woude’s bill would exempt beneficiaries with children under age 18.
The bill would also seek a federal waiver to change retroactive Medicaid eligibility from 90 days to 30 days, and would direct the state government to screen recipients for drug and alcohol abuse so they could be referred to treatment, according to the legislation’s statement of purpose.
It would also provide Medicaid expansion recipients an option of using tax credits to procure plans from the state-run health insurance exchange, though that would also require a federal waiver. It would also add a clause nullifying Medicaid expansion if the federal government’s cost-sharing dipped below 90 percent, unless the Legislature intervenes.
The ongoing cost to the state government of adding these changes would be $1.48 million annually, according to the statement of purpose.
“I believe there’s always a benefit if we can help people move off of a government program and be self-sustaining,” Vander Woude told lawmakers this week.
Democrats, including District 26’s three lawmakers, have opposed efforts to add restrictions to the voter-approved measure.
Senate Minority Leader Michelle Stennett, D-Ketchum, Rep. Muffy Davis, D-Ketchum, and Rep. Sally Toone, D-Gooding, met with constituents at town hall meetings last month and expressed their intent at blocking any attempt to add new restrictions or requirements. Davis is a member of the Health and Welfare Committee.
At a recent town hall event in Ketchum, Stennett said they would support an opt-in work training program, similar to one implemented in Montana.
“Work requirement, we don’t support,” Stennett said. “Everything that is extra, that is not part of plain Medicaid expansion, the federal government said they would not fund.”
On Wednesday, the House Environment, Energy and Technology Committee held a hearing devoted to the effects of climate change in Idaho, including longer and more severe wildfire seasons, diminishing mountain snowpack and earlier snowmelt, the economic ramifications to tourism and agriculture, and energy production and consumption.
Boise State University professor Jennifer Pierce kicked off the testimony by stating that the size, frequency and intensity of fires have grown as the earth’s temperatures have increased.
She said that has resulted in a “smoke season” in Idaho that now spans 20-plus days, when the air quality is unhealthy and residents should limit the time they spend outside. Much of the wildfire smoke in Idaho originates from out-of-state fires.
She said the Legislature could pass laws prohibiting or limiting the use of fireworks, tracer bullets, exploding targets and vehicles driving over dry grass to help prevent more human-caused wildfires.
“There is now a smoke season from July to about October,” Pierce said. “We’re going to have more of our water delivered as rain instead of snow. This is a very profound change. Our low flows will get lower in the summer. The timing of that streamflow will shift earlier and earlier in the year.”
Rep. Laurie Lickley, R-Jerome, asked about other land-management methods of preventing wildfires, such as logging or grazing.
“I’m fond of saying, ‘Log it, graze it or watch it burn,’” Lickley said.
Pierce responded by saying that imposing different land management techniques to prevent wildfire is complicated in Idaho, because lower-elevation forests consisting mainly of ponderosa pine trees are different from higher-elevation lodgepole pine forests. The lodgepole forests are some of Idaho’s most fire-prone, but it’s much tougher to thin those forests.
“For many of Idaho’s forests, this is not economically or ecologically viable,” Pierce said.
Jaap Vos, a professor at the University of Idaho, said wildfires have a significant economic impact in Idaho. He cited the Pioneer Fire, which burned almost 200,000 acres near Idaho City in 2016. The fire closed access to yurts, campgrounds and trails, which harmed small businesses in Idaho City that rely on tourism.
“The small businesses in Idaho City were severely impacted by the Pioneer Fire,” Vos said.
The Legislature’s target for sine die—adjournment—is Monday, March 25, meaning lawmakers will have to wrap up their business in the week prior if they intend to hit that deadline.