Friday, January 26, 2024

During the third week of the legislative session, several bills were introduced that impact IMA priorities. Below is a brief summary of the relevant legislation.

Medicaid Expansion Repeal Bill

On January 22, Rep. Jordan Redman (R-Coeur d’ Alene) introduced HB 419, legislation that would create 11 different “triggers” – conditions that, if unfulfilled, would repeal Medicaid Expansion. Some of those conditions include:

• Work requirement for participants
• Enrollment cap of 50,000 people, nearly a 50% reduction
• Lifetime benefit limit of 36 months
•  Biannual redeterminations
•  Prohibition of coverage for gender affirming care

If signed into law, all waivers would be required to be submitted by the end of September 2024, and all conditions would need to be met by July 1, 2025. If at any time a condition is unfulfilled, the State would have 90 days to repeal Medicaid expansion, disenrolling nearly 100,000 people.

It is important to note that most of the conditions proposed in HB 419, regardless of presidential administration, have never been approved because they are in violation of waiver rules. HB 419 removes control from the State of Idaho and places the power of expansion repeal into the hands of federal agencies and courts. It’s also important to note that Idaho will incur significant increased costs in other areas with the loss of Medicaid expansion. IMA is opposed to this legislation and is actively working with stakeholders to hold it in committee.

On January 23, Rep. Dori Healey (R-Boise) introduced HB 423, which would reinstate the MMRC in a manner more closely resembling the former committee, a different approach from HB 399, which we highlighted last week. 

You may recall it was Rep. Healey who introduced legislation last year that would have removed the sunset on the former MMRC, making it permanent. That legislation was heavily debated but never proceeded from the House Health and Welfare Committee. HB 423 would make the Department of Health and Welfare the administrator of the committee – another significant change when compared to HB 399.

At this time, it is unknown which bill the House Health and Welfare Committee will advance or if there will be a third bill. However, the lobby team is encouraged by the interest and support to reinstate the MMRC and will continue to work with stakeholders to see that the committee is restored.

Assistant Physician

In 2023, IMA worked closely with Rep. Josh Wheeler (R-Ammon) and Rep. Chenele Dixon (R-Kimberly) as they introduced the Bridge Year Physician bill. HB 153 was signed into law and created a one-year, non-renewable limited license for unmatched medical school graduates, allowing them to work under a supervising physician while preparing to re-enter the residency match process.

On January 22, Rep. Jordan Redman (R-Coeur d’ Alene) introduced HB 418, significantly changing the Bridge Year concept. HB 418 would create Assistant Physicians, a concept that has been attempted in a handful of states, and create a three-year limited license, circumventing the residency process entirely. After a three-year apprenticeship and passing the 3^rd step of the United States Medical Licensing Examination (USMLE), the Assistant Physician would be eligible to become licensed as a general practitioner.

IMA is opposed to this concept. Fortunately, Rep. Redman has been very receptive to the concerns expressed by the lobby team. We will keep you posted with updates as they become available.

Throughout the Legislative Session, IMA monitors legislation and provides status updates every Friday. Click here to view the IMA Bill Tracker.