{"id":8841,"date":"2012-07-06T12:11:16","date_gmt":"2012-07-06T18:11:16","guid":{"rendered":"http:\/\/stateimpact.npr.org\/idaho\/?p=8841"},"modified":"2012-07-17T14:58:49","modified_gmt":"2012-07-17T20:58:49","slug":"if-idaho-opts-out-of-medicaid-expansion-low-income-adults-could-be-in-limbo","status":"publish","type":"post","link":"https:\/\/stateimpact.npr.org\/idaho\/2012\/07\/06\/if-idaho-opts-out-of-medicaid-expansion-low-income-adults-could-be-in-limbo\/","title":{"rendered":"If Idaho Opts Out Of Medicaid Expansion, Low-Income Adults Could Be In Limbo"},"content":{"rendered":"
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John Moore \/ Getty Images<\/p>

It's not yet clear whether Idaho will elect to expand Medicaid eligibility and accept federal funding provided under the health care law.<\/p><\/div>\n

Last week’s Supreme Court ruling on the federal health care overhaul\u00a0left states with important decisions to make<\/a>.\u00a0 One of the main questions is whether to go along with the Affordable Care Act’s Medicaid expansion.<\/p>\n

So far, Idaho Gov. C.L. “Butch” Otter is not among the ten Republican governors swearing off the expansion<\/a>.\u00a0 But if Idaho does<\/del> go that route, a sizable percentage of Idahoans who live below the poverty line could find themselves in a kind of limbo with respect to the law.<\/p>\n

<\/del>This graphic<\/a> from The Washington Post<\/em> lays out the problem.\u00a0 If states opt in, all residents with incomes up to 133 percent of the poverty line will be eligible for Medicaid<\/a> coverage.<\/p>\n

In many states that might opt out, however, there would be a gap between the poorest of the poor — who the states already cover with Medicaid — and those who earn too much to qualify for Medicaid, but whose incomes leave them below the poverty line.\u00a0 Anyone stuck in this middle ground still would not qualify for Medicaid under the old rules.\u00a0 Nor would they get the subsidies under the new rules.<\/p>\n

In Idaho, the number of people who fall into that gap could be significant.\u00a0 Why?\u00a0 Let’s use a two-person family — one adult and one child — as our example.\u00a0 In that case, the adult is Medicaid-eligible in Idaho only if the family’s income is $251 per month or less<\/a>. That works out to $3,012 annually, which is just under 20 percent of the 2012 federal poverty guideline<\/a>.<\/p>\n

Parents who fall above that 20 percent threshold but below the federal poverty line would be left without Medicaid eligibility, and without access to subsidized private health plans.<\/p>\n

Idaho Department of Health and Welfare spokesman Tom Shanahan says agency officials are hopeful the Centers for Medicare & Medicaid Services (CMS) will address that no-man’s land that now exists in the law.\u00a0 He says CMS originally wrote guidance for states under the assumption that all would expand their Medicaid programs.\u00a0 However, the Supreme Court’s decision makes it much simpler for states to opt out of that expansion<\/a>.<\/p>\n

While the Department of Health and Welfare awaits guidance from CMS and state leaders, it has assigned a Utah-based consulting group<\/a> the job of assessing the population that would receive coverage if the state does elect to expand its Medicaid program.\u00a0 A report is due mid-August.<\/p>\n

In all of this, it’s worth noting that Idaho’s Medicaid<\/a> eligibility thresholds for low-income adults with children* have not budged since the mid-1990s.\u00a0 The state adopted the most restrictive eligibility level allowed under the 1996 welfare reform law, Shanahan explains, and hasn’t changed the dollar amount since.\u00a0 “Idaho has always had a fairly restrictive Medicaid program,” he says.<\/p>\n

*We originally reported that “Idaho’s Medicaid eligibility thresholds have not budged since the mid-1990s.”\u00a0 In fact, it is eligibility thresholds for low-income adults with children that have not changed.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

Last week’s Supreme Court ruling on the federal health care overhaul\u00a0left states with important decisions to make.\u00a0 One of the main questions is whether to go along with the Affordable Care Act’s Medicaid expansion. So far, Idaho Gov. C.L. “Butch” Otter is not among the ten Republican governors swearing off the expansion.\u00a0 But if Idaho […]<\/p>\n","protected":false},"author":46,"featured_media":2775,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[15],"tags":[24,64,119,65],"acf":[],"_links":{"self":[{"href":"https:\/\/stateimpact.npr.org\/idaho\/wp-json\/wp\/v2\/posts\/8841"}],"collection":[{"href":"https:\/\/stateimpact.npr.org\/idaho\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/stateimpact.npr.org\/idaho\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/stateimpact.npr.org\/idaho\/wp-json\/wp\/v2\/users\/46"}],"replies":[{"embeddable":true,"href":"https:\/\/stateimpact.npr.org\/idaho\/wp-json\/wp\/v2\/comments?post=8841"}],"version-history":[{"count":1,"href":"https:\/\/stateimpact.npr.org\/idaho\/wp-json\/wp\/v2\/posts\/8841\/revisions"}],"predecessor-version":[{"id":8876,"href":"https:\/\/stateimpact.npr.org\/idaho\/wp-json\/wp\/v2\/posts\/8841\/revisions\/8876"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/stateimpact.npr.org\/idaho\/wp-json\/wp\/v2\/media\/2775"}],"wp:attachment":[{"href":"https:\/\/stateimpact.npr.org\/idaho\/wp-json\/wp\/v2\/media?parent=8841"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/stateimpact.npr.org\/idaho\/wp-json\/wp\/v2\/categories?post=8841"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/stateimpact.npr.org\/idaho\/wp-json\/wp\/v2\/tags?post=8841"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}