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Medicaid Gap

Layne Andrews (center) talks about his chronic pain before one of his doctors appointments April 19, 2016, in Twin Falls. To his left is his mother, Kathleen Andrews, and to his right is his friend Krista Smith, who is also uninsured and has numerous health problems including a severe form of spina bifida.

The Affordable Care Act was enacted in March 2010 — nearly eight years ago to the day that Idaho lawmakers spiked a dual-waiver health care plan, leaving tens of thousands of Idahoans uninsured.

HB 464, aimed at providing health care for Idahoans in the so-called Medicaid gap, effectively died in the House Wednesday, as Rep. Fred Wood, R-Burley, sent the bill back to committee for the second time. Despite impassioned debate, the bill never received a vote from lawmakers.

The bill would have let the state apply for two waivers from the federal government: one that would let working poor adults buy subsidized health insurance on the state’s health care exchange, and another that would allow people with severe illnesses to receive insurance from Medicaid.

The Idaho Department of Health and Welfare estimates that between 51,000 and 62,000 people — roughly 3 to 3 1/2 percent of the state’s population — fall into the Medicaid gap. But lawmakers apparently find that number not worthy of urgent action. So unworthy, in fact, that they’ve failed for six straight years to close the gap.

It’s a tough sell for Republicans to risk being branded as a “Medicaid expander” during an election year. If that seems like a backward philosophy of governance, rest assured that it is.

House Speaker Scott Bedke, R-Oakley, said killing this bill kept the issue alive. He acknowledged the skeptics among us when he said, “Some would claim it to be for the good of the issue, long-term. Others would say it’s just political maneuvering.”

It sure feels like the latter, as plenty of lawmakers are up for reelection this year.

Maybe we’ll find out whether it was just political maneuvering during the 2019 legislative session. But given that lawmakers have had six tries to rectify this and have failed to do so for six straight sessions, that seems unlikely.

In the meantime, more than 3 percent of the state’s population goes without insurance, and the Medicaid gap stays open.


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