BOISE — About 35,000 Idaho residents have signed up for Medicaid under expanded coverage in the first few days it has been offered, state officials said Nov. 4.
The Department of Health and Welfare said that’s more than a third of the estimated 91,000 people who are eligible. The agency started taking applications Friday, and it is tracking numbers on its website. Voters authorized Medicaid expansion last year with an initiative that passed with 61% of the vote after years of inaction by state lawmakers. But lawmakers earlier this year added restrictions requiring five waivers from the U.S. Department of Health and Human Services’ Centers for Medicare and Medicaid Services.
Waivers are required when states want to deviate from Medicaid rules. Federal officials have yet to approve any of Idaho’s requested waivers, but enrollment is proceeding with coverage starting Jan. 1.
The expansion provides Medicaid to people earning up to a maximum of 138% of the federal poverty level. That maximum is about $17,000 a year for one person and $35,500 for a family of four.
Of Idaho’s estimated 1.8 million residents, about 286,000 as of Sept. 1 were covered by Medicaid, according to the Department of Health and Welfare. Medicaid expansion would add an estimated 90,000 people costing $400 million, with the federal government paying 90%.
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Also on Monday, state lawmakers on the Committee on the Equitable Assessment of Costs Related to Medicaid Expansion met to figure out how to pay Idaho’s $40 million share. Their recommendations will be used when the Legislature convenes in early January. The Medicaid expansion passed by voters didn’t include a funding source.
“Nevertheless, we will continue to look at offsetting the costs of expansion so that we remain respectful of the Idahoans who elected us to be fiscally conservative with their tax dollars,” Republican Rep. Megan Blanksma, a committee member, said in a statement.
During the Legislative session earlier this year, backers of waivers said they would save Idaho money. Four of the waivers have been submitted so far.
Most recently, Idaho last month submitted a waiver requiring patients to get referrals from primary physicians before they can get family planning services such as birth control, abortions or pregnancy care.
Idaho submitted a work requirement waiver in September requiring recipients age 19 to 59 to work 20 hours a week to remain eligible for Medicaid. There are exemptions for medical conditions.
The Centers for Medicare and Medicaid Services in August rejected a “choice” waiver request Idaho submitted as incomplete that would allow Idaho residents who qualify for the expansion to choose to stay on the state’s health insurance exchange.
Idaho Health and Welfare officials are working with federal officials to supply the necessary information.
A similar choice waiver is on hold because federal officials have told the state it may not be necessary.
A final wavier is expected to be released for public comment this month. It would allow Medicaid recipients to receive inpatient treatment for mental health and substance abuse disorders at a freestanding psychiatric hospital. Currently, those services are only available in the psychiatric unit of a full-service hospital.
The waivers could take months to process, with final decisions occurring after coverage starts and changing who is covered. State officials have said they will work through those issues as they arise.