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HHS rejects one Medicaid expansion “guard rail”

Update: 8-30

Governor Brad Little, Senate Pro Tem Brent Hill, and House Speaker Scott Bedke issued a joint statement in response to a decision by the federal Centers for Medicare and Medicaid Services (CMS) saying Idaho’s 1332 Coverage Choice waiver application is “incomplete.”

“We are disappointed and surprised by the assessment from CMS about our 1332 waiver application after the amount of work and coordination Idaho spent with our federal partners in developing the application.

“Simply put, CMS pulled the rug out from under us. For months, state agencies worked closely with the federal agencies on the purpose and goals of the waiver application. We shared multiple strategies and considerations about how Idaho would approach the cost neutrality portion of the application. At no time during those conversations did the federal government indicate Idaho’s approach to the budget neutrality guardrail would be insufficient for consideration.

This waiver remains a high priority for Idaho. It is important to give Idahoans the choice to stay on private coverage rather than forcing them to public assistance. The State of Idaho is already taking steps to submit the additional information required by CMS so that our application can be fully considered on its merits.”

Original Story:
The Department of Health and Human Services Centers for Medicare and Medicaid Services has rejected the Idaho Legislature’s application for restrictions to the state’s Medicaid Expansion.

The legislature tried to steer otherwise eligible participants onto expensive exchange-based health insurance plans. Idahoans earning between 100-138% of the federal poverty level, who qualify for Medicaid Expansion, would have been given a “choice” to buy plans on the Idaho exchange with taxpayer-funded tax credits.

It was one of the many “guard rails” the Legislature added to Medicaid Expansion in 2019.

But, the HHS review said that even if Idaho tried to reapply, its requirements would push the costs too high. The letter called the state’s application “incomplete” and said it could not “demonstrate deficit neutrality.”

You can see the response to the state Insurance Director Dean Cameron here.

“This is what happens when angry legislators try to steer working Idahoans onto plans that offer less comprehensive coverage for higher costs and greater out-of-pocket expenses,” said Rebecca Schroeder, Executive Director of Reclaim Idaho. “This was a bait-and-switch healthcare scheme promoted as a ‘choice’ but geared toward giving Idahoans less healthcare coverage at higher prices to patients and taxpayers.”

Liz Woodruff, Assistant Director of the Idaho Voices for Children, agreed. “It was clear from the beginning that the coverage choice concept would not be able to meet the deficit neutrality requirement that a policy won’t increase the federal deficit. It is simply more cost- effective to cover the expansion population with Medicaid. We are grateful that CMS took comments from Idahoans into consideration when reaching its determination,” she said.

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