Idaho Activists Plan to Put Medicaid Expansion on the Ballot

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By Paul Shukovsky

Medicaid expansion advocates in Idaho aim to do an end run around the state’s Republican-controlled Legislature by bringing the issue directly to the electorate in a November 2018 ballot measure.

Reclaim Idaho, a new political action committee with about $11,000 in the bank and youthful leadership, filed an initiative petition earlier in October with the secretary of state’s elections office that would expand Medicaid eligibility to people under 65 whose modified adjusted gross income is 133 percent of the federal poverty level or below.

At stake is the health plan coverage, or lack thereof, for some 78,000 Idahoans dubbed the “gap” population because they earn too much to be eligible for Medicaid, but not enough to buy coverage on the state health insurance exchange. Expansion of Medicaid coverage under the Affordable Care Act is optional, and advocates of coverage are trying other avenues to get state policy makers to cover more people.

The language of the initiative is virtually identical to that of a 2016 Medicaid expansion bill, SB 1204, sponsored by a Democrat that died in the Senate Health and Welfare Committee. But Reclaim Idaho co-founder Luke Mayville thinks its death reflects what he calls “the state’s extreme right-wing politics” rather than the will of the people, he told Bloomberg Law Oct. 26 in a telephone interview.

Since the advent of the Affordable Care Act, Gov. Butch Otter (R) has convened several task forces and committees to address the “gap” population, which have reported back that Medicaid expansion would save Idaho money while providing health-care coverage to the 78,000 members of the gap. But the Legislature is controlled by Republicans who are ideologically opposed to Obamacare and fear the consequences for Idaho as the federal government ramps down financial support for the coverage expansion.

Medicaid Camper Tours State

Mayville says his optimism about the measure’s chances to gather with volunteers the 56,192 signatures needed to get on the ballot and go on to victory in November 2018 stems from two sources: polling numbers and a road trip around Idaho in an old Dodge camper.

About 70.8 percent of 1,000 Idahoans told pollsters from Boise State University’s School of Public Service in December 2016 that “they were in favor of the state Legislature taking action to provide access to quality health care for low income Idahoans who currently lack affordable comprehensive health coverage,” according to the poll report.

The road trip featured the refurbished camper, painted bright green with “Medicaid for Idaho” emblazoned across the side. Even in some of the most rural, deeply-conservative parts of the state, Mayville said he was greeted by people who shared their health-care coverage challenges and were eager to add their signature to the side of the van in support of Medicaid expansion when Mayville explained the policy involved.

The Boise State poll found generally strong support across all regions of the state with Republicans showing the lowest level of support at 59.1 percent in favor of providing quality health-care for low-income Idahoans.

“The expansion of the Medicaid Program is the perfect cause because it would do an enormous amount of good for the state by making health care accessible to close to 80,000 people; is vastly popular; and would be a net budgetary gain for the state,” Mayville said. The legislative fiscal note accompanying SB 1204 shows net state and county savings of $43.7 million in 2017 if Medicaid expansion had been enacted.

Maine, Utah in Play

Mayville says he’s looking forward to the outcome of a ballot measure in Maine in November that would mandate the provision of Medicaid to people earning at or under 138 percent of the federal poverty level. In Utah, a ballot initiative was filed at the beginning of October to expand Medicaid.

But it’s still early days for the Medicaid for Idaho campaign. If the initiative petition passes legal muster at the state attorney general’s office, a short and long description of the initiative will be approved and the petition would likely be ready for circulation some time in the middle of November, Tim Hurst, chief deputy at the Idaho secretary of state’s office told Bloomberg Law Oct. 26.

To contact the reporter on this story: Paul Shukovsky in Seattle at

To contact the editor responsible for this story: Brian Broderick at

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