BOISE, Idaho — The House on Thursday amended Medicaid expansion legislation to remove Idaho recipients from Medicaid coverage if they fail to meet work requirements.
Shortly after making those changes, the House suspended the rules, debated the bill and voted on it. It passed out of the House on a 49-20 vote.
Lawmakers made the changes to the legislation, received from the Senate days earlier, as the two chambers attempt to reach a compromise that can win the approval of Republican Gov. Brad Little.
The amendment bill would remove able-bodied recipients for two months. But recipients could immediately get back coverage if they get a job or prove they meet the requirements through training or school.
A Senate committee last month killed legislation originating in the House that kicked people off Medicaid for failing to meet work requirements.
The Senate "understood full well when they sent it over here that we had intentions of amending it," said Republican House Speaker Scott Bedke during a break in proceedings. "So we have."
Voters authorized Medicaid expansion with an initiative in November with 61% of the vote after years of inaction by the Legislature.
The expansion will provide access to preventative health care services for an estimated 91,000 low-income residents. The federal government would cover 90 percent of the estimated $400 million cost.
The Senate previously passed an appropriations bill paying for Medicaid expansion as approved by voters with no work requirements. Little has included $20 million for the expansion in his budget.
But the House has refused to vote on the appropriations bill because a majority of members appear to want work and other requirements for Medicaid recipients. Other concerns include the state getting stuck paying more if the federal government reduces its 90% portion of the Medicaid cost.
That was the focus of another amendment approved Thursday that requires lawmakers to declare Medicaid expansion in Idaho null and void if the federal government portion drops below 90 percent.
Last month, a federal judge in Washington, D.C., blocked Medicaid work requirements in Arkansas and Kentucky. The judge ruled that the requirement for low-income people posed numerous obstacles to getting health care that hadn't been adequately resolved by federal and state officials.
That ruling appeared to play a part in sinking the House's Medicaid expansion bill last month.
Democratic Rep. Ilana Rubel said the amendment on Thursday adding back in a provision to remove people from Medicaid meant Idaho would lose in court. "They just said you can't take people's Medicaid away for not meeting the work requirements," she said.
Several amendments offered by Democrats failed in the Republican-dominated House. One of those would have ensured that individuals have access to job training, job-search resources and educational opportunities. Another amendment would have protected from discrimination jobseekers who are gay, lesbian and transgender.
Because the House has passed the bill, it will head back to the Senate to see if that chamber agrees with the changes.