Idaho, it’s time for a special session — or a $100 million hole in grandma’s pocket | Opinion

It’s time for the words no one in Boise ever wants to hear: Gov. Brad Little needs to call lawmakers back to the Capitol immediately.

Idaho lawmakers’ desire to be done with the legislative session and get back home to campaign before the May primary could soon cost your grandparents dearly.

A bill designed to give the Legislature more direct control over the state’s Medicaid program seems to have been poorly drafted. On top of that, it was slapped with an emergency clause that made it take effect immediately.

The bill, House Bill 398, requires that the Legislature give its approval to certain Medicaid waivers, which allow the state flexibility in its implementation of the mostly federally funded program. Little signed the bill Monday, but in his transmittal letter noted that it could have catastrophic consequences if lawmakers didn’t follow up with a bill clarifying that ongoing programs weren’t subject to the law.

In all, over $100 million in unexpected and unintended Medicaid cuts could be made by the bill if it wasn’t followed up with an amendment, Little warned lawmakers.

“Imminent action by the Legislature is necessary to provide the state with clarity and confidence that legal authority exists to continue with program implementation,” Little wrote.

Rep. Megan Blanksma, R-Hammett, the bill’s sponsor, told the Idaho Capital Sun that the bill wasn’t intended to disrupt current programs. She indicated that a trailer bill like Little discussed had been drafted. But this week, the Legislature adjourned without passing it.

The medical providers directly impacted are panicked. They inundated the governor’s office with panicked letters outlining their concerns before the end of the session:

• “If this bill (the trailer bill) does not pass, we think this will be the largest cut to the Medicaid program in the history of Idaho and we doubt this was the intention of most legislators who voted to pass the bill. There is no option to wait for a special session,” wrote Robert Vande Merwe, executive director of the Idaho Health Care Association.

• “We are deeply concerned that this law could disrupt the implementation of Idaho Behavioral Health Plan amendments, redirect payouts to Idaho’s skilled nursing facilities, halt up to $70 million in rate adjustments for providers, and prevent the submission of approval of $4 million for the reinstatement of personal care services management,” wrote Matt Bell, president of the Idaho Association of Health Plans.

• “Without an amendment, the current enacted Idaho HB 398 mandates that IDHW immediately cease implementing waiver amendments of the (Idaho Behavioral Health Plan), including certain behavioral health services and residential treatment centers for substance use and psychiatric disorders. The IBHP provides essential services including care for persons with serious mental illness, addiction, and autism. Without needed care, the risk for adverse outcomes and higher downstream costs is very real,” wrote Magellan Behavioral Health president and chief medical officer Caroline P. Carney.

A $100 million cut through legislative fumbling can’t simply be allowed to stand. Especially not when it’s what allows seniors with no assets remaining to stay in nursing homes, or what pays for people with disabilities to have their basic needs for life met.

Little has a big lever he can pull to help fix this problem, and he should pull it. He can call a special session — not in a few months, not after the primary, but now.

Why should lawmakers have time to go home and campaign to keep their jobs if they haven’t finished their work? Or, if they really do intend to cut off care to seniors, the disabled and people with serious mental health disorders, let them make that intention clear so that voters can take it into account this election cycle.

Bryan Clark is an opinion writer with the Idaho Statesman.