Medicaid Expansion Update

Last week, the Lobby Team provided an in-depth look at Medicaid Expansion and the Idaho Legislature’s review of the program. Letters of recommendation from the House and Senate Health and Welfare Committees were due January 31st. Those letters were submitted separately but both echoed the same themes - Medicaid Expansion should remain in place but there are serious concerns regarding sustainability. While sustainability is a concern, it was recognized that an abrupt conclusion to the program could be harmful to Idahoans. According to data previously presented by the Department of Health & Welfare, terminating Medicaid Expansion would cost the state more money than continuing the program.

There is a sense of urgency to complete the redetermination process, the process of removing those that no longer qualify for the Expansion program, as soon as possible. In fact, the House has requested that all redeterminations be completed by July 1, 2023.

Finally, although the two committees agree regarding the continuation of Medicaid Expansion, both committees want the ability to review the program within the next two years. First, the Committees are requesting that the Department review the program in 2024, giving the Department time to implement the Committees’ current recommendations. Second, the Committees are requesting a complete review by both House and Senate committees in 2025.

You can review the House and Senate letters by following the links below.

House of Representatives letter

Idaho State Senate letter

Criminalization of Gender Affirming Care for Minors

In March 2022, Rep. Bruce Skaug (R-Nampa) introduced HB 675, a controversial bill that would have criminalized evidence-based gender affirming care (GAC) for minors. It passed quickly through the House but was never heard in the Senate. A subsequent statement was released by GOP senators stating that, among other things, the bill “undermines parental rights and allows the government to interfere in parents’ medical decision-making authority for their children.”

On Jan. 31, Rep. Skaug introduced HB 71, the Vulnerable Child Protection Act, that largely mirrors his bill from last year - again making it a felony to provide surgery, hormone therapy, and puberty blockers to minors suffering from gender dysphoria. Notable differences highlighted during the introduction hearing include protection for boys and a reduced prison sentence, now 10 years instead of life in prison, for those physicians who provide GAC services.

“Bridge Year Physicians”

Also on Jan. 31, Rep. Josh Wheeler (R-Ammon) and Rep. Chenele Dixon (R-Kimberly) introduced HB 62, which would create a limited license for medical school graduates who do not match into a residency program. They are referring to this designation as “bridge year physicians”.

This concept has been explored in other states, with the designation of “assistant physician”. However, HB 62 is much more narrow, allowing the unmatched graduate a nonrenewable, one-year license and requiring the individual to practice under the supervision of a licensed Idaho physician. The Idaho Board of Medicine would oversee the program and be responsible for establishing scope of practice and prescriptive authority. HB 62 is awaiting a hearing in the House Health and Welfare Committee.