February 25, 2019: Medicaid Expansion and Sideboards
Week 7 Newsletter
We just finished the seventh week of the legislature and it feels like we are waiting for a several big issues to move! The two defining issues of the legislature are how we handle Medicaid Expansion (Proposition 2) and the new school funding formula. We’ve made progress on Medicaid Expansion but the work on the school funding formula goes on behind closed doors. Stay tuned on both of these big issues.
Medicaid Expansion and Sideboards
On Thursday, two bills presented in committee were attempts to repeal Idaho’s Medicaid Expansion - one to repeal the expansion completely, the other to repeal the expansion if the projected healthcare savings fall short. Both of these bills were rejected!
Governor Little also made it clear on Thursday that he expects the legislature to fund Medicaid Expansion and he will not let us go home without funding it.
It is really important to have Governor Little’s support at this time. Medicaid Expansion wlll get funded! The battle now is about potential bills that attempt to place sideboards on the funding, either restricting it or repealing it altogether. Medicaid Expansion is important for the health and welfare of our state and a clean implementation with no restrictions follows the will of the people who overwhelmingly voted for Proposition 2.
We expect some additional bills with sideboards to come out soon. Keep watching so we can insure clean implementation. Voters passed proposition 2 in the fall and that is now part of Idaho code. A clean implementations means we don’t pass any additional laws that change the will of the people.
Dental Health Therapist Bill
We passed a bill in the Senate Health and Welfare committee, sponsored by the Coeur d'Alene Tribe, to legalize mid-level dental care provider on or adjacent to Native American reservations.
This bill was a compromise that came after many months of discussions between the Coeur d’Alene Tribe, the Idaho Dental Board, and the Idaho Dental Association. As with many compromises, no one is completely happy with the outcome. The bill restricts these providers to clinics and health care facilities on or near the reservations, but doesn’t address the need for dental care in other parts of Idaho where many of our dentists do not accept Medicaid clients. Dentists and hygienists are concerned about the bill because it legalizes a new type of provider service; they want to ensure that the public’s dental health is protected. Despite these challenges, I think this a good start. It took a long time to get physicians assistants defined and accepted into medical practice. Now we are starting to do the same for dentistry.
This bill provides access to dental care for Idaho’s currently undeserved reservation populations. The mid-level dental health care program was started in Alaska and has been adopted in other states. Our tribal communities are not as remote as those in Alaska, but they face many of the same systemic barriers to good oral health care. This legislation provides for training of tribal members in mid-level dental care skills so they can help other tribal members in a much shorter time frame than other (fully licensed?) dental care professionals. Here is how it worked in Alaska.
On Monday, February 18th, the Senate approved SJR 101, a proposed amendment to update Idaho’s existing constitutional rights for victims of crime, also known as Marsy’s Law for Idaho. I voted in favor, and the bill passed 25 to 9 with 1 senator absent.
The legislature has been wrestling with this issue for three years. The sponsors of this amendment have crafted some good legislation, and, if it passes the house, we will all get to vote on this constitutional amendment in 2020.
There was a flurry of late emails on this bill, complaining it would infringe on our Second Amendment rights. I read the bill forwards and backwards and forwards again, trying to see how this would be possible. The bill clearly states that the federal Constitution is superior and our Idaho Constitution has superior protections in place as well.
Marsy’s Law is supported by Idaho prosecutors, law enforcement officers, victim advocacy groups and other community leaders because it is good, common sense legislation. The co-sponsors of the bill include many legislators like Bert Brackett and Carl Crabtree, who are not shrinking violets on protecting our Second Amendment rights.
Driver’s Education Instructor Training
I was in the Senate Transportation Committee meeting on Tuesday, reviewing an innocuous-seeming bill - HB45, which changes requirements for training driver’s education instructors. The bill passed the house 68 to 0, and is one of many bills written to reduce restrictions the state places on different professions through the Bureau of Occupational Licensing. The legislature has justifiably placed a priority on reducing these burdens and has done some good work. For example, the entire Medical Practices Act was rewritten, modernized and simplified and we easily passed HB9 to complete this process.
But, HB45 is different. It cuts the requirements for a driver’s education instructor for classroom hours from 60 to 30 and behind the wheel training from 108 to 16 hours. Pretty big changes. The committee asked some questions about the data behind such a big change. Is there any study that shows the lesser amount of training was as effective as the longer training? What would be cut out of the current curriculum? What are neighboring states doing? The Bureau presented some data on our neighbors, but we also saw some other data that challenges the wisdom of making such reductions in training. This was enough for me to vote no on the proposed bill. New teen drivers, our kids, already have high accident rates. We need to make sure they have the best driving skills possible and good driving instruction is critical. It seemed irresponsible to pass this bill without better information.
I am pleased to report that when the motion was made to bring the bill up for a vote, no one would second it, so it died for lack of a second.
What did I learn from this?
Don’t rush on legislation. Make sure you have all the facts. This bill might have died because the sponsors took their presentation for granted.
Ask good questions. I asked about the data on why this was a good idea. I asked about our neighboring states.
The chambers of the legislature don’t give each other free passes. This bill had passed the house 68-0, but died for lack of a second in a Senate committee.
On the vast majority of issues, our members work together for our common good. This was not a party issue, it was an issue about safety on the roads - for ourselves and our kids.