Idaho’s Last-Minute Backdoor ObamaCare Expansion Would Be a Mistake

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For the past several years, Idaho lawmakers have rejected every attempt to bring Obamacare’s Medicaid expansion to the Gem State. Earlier this year, they rejected two expansion plans that were so unpopular, they failed to even earn a committee vote. But with the legislative session winding down, there’s another last-minute, backdoor attempt to expand Medicaid on the horizon.

The latest plan, dubbed the “Idaho Accountable Care Waiver Act,” would require the state to “provide for managed Medicaid services” to a new class of able-bodied adults. Although the legislation nominally limits its Medicaid expansion to able-bodied adults below the poverty line, it immediately thereafter says that the expansion shall be “in accordance with” Obamacare’s Medicaid expansion provisions.

Under federal law and regulatory guidance from the Obama administration, the only way for an expansion to be “in accordance with” those provisions is to expand Medicaid to all able-bodied adults earning less than 138% of the federal poverty level. The enhanced federal funding available under those provisions can only be received if a state expands Medicaid under Obamacare.