Wednesday, December 5, 2018

Idaho Medicaid expansion heads to state Supreme Court


By Susannah Luthi  | December 5, 2018
(Updated at 3 p.m. ET)

Idaho's highest court on Wednesday agreed to consider a lawsuit seeking to reverse the state's voter-approved Medicaid expansion.

On Jan. 29, justices in the GOP-majority state will consider the Idaho Freedom Foundation's complaint that Medicaid expansion is unconstitutional. Idahoans passed a ballot measure with a 60% majority in November to expand the healthcare program.

"A sweeping and general delegation of legislative power with uncontrolled, unrestricted or unguided discretionary power exceeds constitutional limits, as does a delegation of lawmaking authority to a state executive branch or the federal government to make future laws governing the issue," the lawsuit said.

A court official said that despite reports that the oral arguments have been expedited, "there is nothing unusual" about the timing.

"It's proceeding just like a usual action that would come to the Supreme Court," said Sara Thomas, administrative director of the courts.

Niki Forbing-Orr, spokesperson for the state's health department, said the target date to unroll the expansion is July 1, 2020. The department expects an appropriation from the Legislature by July 1, 2019, which is the start of the next fiscal year.

The actuarial firm Milliman estimated that expansion will cost Idaho about $45 million a year for its small share of the total funding, but will generate about $40 million in state and local funds.

"The single year net cost to the state will vary year over year, but the net total 10-year cost estimate from state fiscal year 2020-2030 in state funds is $105.1 million, once costs and savings are accounted for," the Idaho's Department of Health and Welfare said in a blog post.

The movement to expand Medicaid gained momentum as Idaho's leaders also mulled alternatives for insuring more people in the largely rural state. A push for a so-called "super-waiver"—a combination of an Affordable Care Act 1332 state innovation waiver and 1115 Medicaid waiver—fell apart in the Legislature last February even though it was touted as an alternative to Medicaid expansion that could bridge the coverage gap.

On the eve of November's vote, outgoing GOP Gov. Butch Otter made news when he endorsed the ballot initiative and urged Idahoans to approve expansion.

Susannah Luthi covers health policy and politics in Congress for Modern Healthcare. Most recently, Luthi covered health reform and the Affordable Care Act exchanges for Inside Health Policy. She returned to journalism from a stint abroad exporting vanilla in Polynesia. She has a bachelor’s degree in Classics and journalism from Hillsdale College in Michigan and a master’s in professional writing from the University of Southern California.

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