Next up in Idaho Medicaid expansion, a ruling from the state Supreme Court


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BOISE (Idaho Statesman) — The Idaho Supreme Court dug into constitutional details Tuesday as it heard from lawyers on both sides of the Idaho Freedom Foundation’s lawsuit against voter-approved Medicaid expansion.

The lawsuit claims that Proposition 2 — which passed on the November ballot with 61 percent of the vote — is unconstitutional. It cedes too much power to the federal government and to the Idaho Department of Health and Welfare, the Idaho Freedom Foundation claims.

At the heart of the conservative group’s argument is the idea that the federal government could someday cut back on how much it subsidizes Medicaid expansion, and the state would be stuck with the costs.

Starting in 2020, when Idaho’s expansion would take effect, the federal government would cover 90 percent of the costs of tens of thousands of Idahoans newly qualifying for Medicaid. (This year, the federal government covers about 70 percent of the costs for people on Idaho’s existing Medicaid program. That share can change as the state’s wages go up and down, but it cannot go below 50 percent.)

The Idaho Supreme Court justices on Tuesday morning focused on a few key themes. They asked pointed questions about whether:

  • the lawsuit meets certain procedural standards to be viable in the first place.
  • ruling the law unconstitutional would have a ripple effect on other Idaho laws.
  • Medicaid expansion truly would put the state in a powerless position.

About 365,000 people in Idaho voted in favor of Prop 2. The ballot measure allows people who make less than 138 percent of poverty-level income to qualify for Medicaid coverage, even if they don’t have children or a disability. Most of them are considered Idaho’s “working poor.”

The Idaho Attorney General’s Office has said that the lawsuit — brought by IFF board chairman Brent Regan — lacks merit and is “frivolous, unreasonable and without foundation on several levels.” Driving home its point, the AG’s office said the lawsuit is so meritless that IFF should have to pay the state’s defense costs.

Since the Idaho legislative session began in January, lawmakers have continued to discuss how they would fund the Medicaid expansion, but most seem committed to moving forward.

After being sworn in, Gov. Brad Little vowed that he would commit to upholding the will of the voters and would support the expansion of Medicaid, although he floated the idea of attaching a work requirement for eligibility.

Lawmakers have not decided whether to add that or other conditions to coverage and are still working on funding the 10 percent.

The Idaho Department of Health and Welfare expects to submit its plan for expansion to federal officials by Feb. 18, even if the Supreme Court hasn’t issued a ruling on the lawsuit. That’s because Prop 2 requires the plan to be submitted within 90 days of the law taking effect.

That plan could be amended or changed or pulled back entirely if the court deems the law unconstitutional, according to a department spokesperson.

The justices will now consider the matter and issue a written ruling.

This article was originally published by the Idaho Statesman. It is used here with permission.