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Idaho High Court Hears Challenge To Medicaid Expansion

Idaho Public Television

The Idaho Supreme Court today [Tuesday] heard arguments on a challenge to the Medicaid expansion initiative approved by voters last November.

Attorney Bryan Smith made the case for the Idaho Freedom Foundation, which is challenging Proposition 2. The measure was approved by 60% of voters. It calls for the state to contract with the feds to fund health insurance for people whose incomes are 133% or less of the federal poverty level. That would make affordable coverage available to tens of thousands of Idahoans who can’t get it now. The feds would pay 90% of the premiums, the state would pay the rest.

Smith argued the state, by accepting expansion, would be subject to federal rules not explicitly approved by the legislature. And he says if the feds decided to, say, change the funding ratio to put more of the burden on the state to pay, Idaho could do little about it, at least in short order.

“When the people voted for Proposition 2, they understood that the federal government was going to pay for 90%. That’s what they understood. Now the federal government could change that," Smith said. "If they change that, then the people just voted for something that becomes different, different from what the law would become in the state, according to the attorney general, and it might be different for years.”

Which, he says, means the state could spend a lot more for Medicaid than it anticipated.

Chief Justice Roger Burdick pushed back.

“If the government changes something, can the state not say, fine, we opt out?” he asked.

Smith said he didn’t know and that would put Idaho in a state of uncertainty. Then Burdick asked if perhaps Smith’s challenge is premature, given there is no agreement yet between Idaho and the feds and therefore the government hasn’t yet insisted on any changes.

The state is scheduled to submit its plan for Medicaid expansion to the government next month. The court has taken the case under advisement.


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