Idaho Legislative Report Week of April 1-5, 2019
2019 IDAHO LEGISLATURE
April 1, 2019 through April 5, 2019
Michael McGrane, RN
This has been a wild week with S 1159 and H 296, the bills to limit voter initiatives moving very rapidly without public hearings or notices. On Wednesday, S1159 passed the House and was sent to the Governor. Also Wednesday, the trailer bill, H 296, passed the Senate and was sent to the Governor. Both bills severely restrict voter initiatives, from requiring signatures from 55,000 registered voters to 92,000 signatures and from 24 vs. 18 of the 35 legislative districts, in order to place an initiative on the ballot. Friday, Governor Little vetoed S 1159 and said he would also veto H 296. Next Monday, the Senate State Affairs Committee will meet to consider overriding the Governor’s veto, although the bill’s passage in the Senate was by a single vote, not enough to override the Governor.
Likewise, it was a hectic week for Medicaid Expansion.
S 1204, the bill proposed by Senator Fred Martin that included job training rather than a work requirement was amended by the Senate Monday removing job training and adding a 20 hour per week work requirement with reporting every six months. But instead of being dropped from Medicaid, a $30 co-pay would be required for those failing to meet the work requirement. The amended S 1204a passed the Senate and was sent to the House. Wednesday, the House Health and Welfare Committee heard overwhelming opposition to the revised S 1204a, but narrowly voted to send the bill to the House floor for further amendments. The House changed the bill again to remove those failing to meet the work requirement from coverage but allowing them to immediately regain coverage if they subsequently meet the work requirement. It also eliminated the $30 co-pay. The amended, amended bill passed the House and went back to the Senate. Friday morning the Senate Health and Welfare Committee met and voted not to concur with the House version but sent the bill to the full Senate where the House amended version passed. It now goes to the Governor with the work requirement. The Department of Health and Welfare submitted an unrestricted Medicaid plan to CMS in February. Should the Governor sign amended S 1204, the Department will submit the “sideboard” restrictions to CMS as waiver requests. CMS can either approve or reject any of the proposals. It is also likely that any work requirement will be challenged in federal court as work requirements in Kentucky and Arkansas were recently held unlawful.
- Adds a 20 hour per week work requirement with six-month work reporting and the ability to immediately return to full Medicaid coverage if dropped but later meets the work requirement,
- Option for those on the exchange to remain on the exchange rather than being on Medicaid;
- Substance abuse reporting;
- Coverage for mental health treatment;
- Required referral for family planning/reproductive services (the Planned Parenthood provision);
- Program review in 2023 with repeal should the 90%/10% federal support change.
The House is still holding funding for Medicaid Expansion. The Governor’s proposal to fund Expansion without sideboards beginning January 1, 2020, passed the Joint Finance Appropriations Committee and the full Senate, but is being held by the House.
Here is a rundown of Medicaid Expansion proposals and their status:
- House bill to fully repeal Proposition 2 – Failed
- Conditional repeal of Proposition 2 if the economic projections fail to appear – Failed
- H 228 - Included a 30 hour per week work requirement, reduces retroactive eligibility from 90 days to 30 days, allowed coverage for behavioral health, allowed those eligible for Medicaid Expansion but receiving coverage under the Exchange to choose between the Medicaid or the Exchange, and made Medicaid Expansion void should the federal government change the funding formula – Replaced by H 249
- H 249 – Revised version of H249 – Withdrawn after public testimony
- H 277 – Would have required 20 hours of work per week with more exemptions, reduces retroactive eligibility from 90 days to 30 days, would require those eligible for the Exchange to be on the Exchange rather than Medicaid, requires referral for reproductive services, and repeals Medicaid Expansion should the federal government funding formula change – Passed House, died in Senate Health and Welfare Committee
- H 290 – Redirects County Indigent Funds and the State Catastrophic Health Care Fund to cover the state’s share for Medicaid Expansion – No action this session, to be basis for Interim Committee on Medicaid Expansion funding
- S 1100 – An early proposal by Senator Mary Souza that would provide job training and support for those covered by Expansion and would repeal Medicaid Expansion in the event the federal/state match changes from 90%/10% to the 70%/30% match for other Medicaid programs – Has not received a hearing in Senate Health and Welfare
- S 1204 – Bill that would Expand Medicaid to cover those in the Gap, 100% - 130% of the federal poverty level, provide job training and support like Montana’s plan, and amended to allow those currently on the Exchange to remain on the Exchange – Passed Senate Health and Welfare Committee, amended by the full Senate to add 20 hour per week work requirement with six-month reporting, $30 co-pay for those not meeting the work requirement, referral for family planning services, mental health coverage and legislative review if 90%/10% federal match changes. Further amended by the House to remove job training and add 20 hours per week work requirement with six-month reporting, dropping those not meeting the work requirement but allowing immediate coverage once the work requirement is met. Amended bill passed the House and passed the Senate – to the Governor
- S 1171 - Medicaid Expansion Budget – Passed Senate, Held in House
- SCR 117 - Medicaid Expansion Interim Committee – Passed
H 109 – Maternal Mortality Review Committee (MMRC) – Signed by the Governor, becomes Law
Idaho’s maternal death rate is 27.1 per 100,000 live births. The US has a maternal death rate of 26.4 compared with Canada at 7.3, UK 9.2, Germany 9, France 7.8 Spain 5.6, Italy 4.2 and Finland 3.8. The bill creates a Maternal Mortality Review Committee within the Department of Health and Welfare. Composition of the committee includes physicians, one midwife, a nurse midwife and one labor and delivery nurse. The committee will study the causes of death and provide recommendations to reduce the death rate. Funding will be entirely covered through a CDC grant.
H 180 – Syringe and Needle Exchange Act – Signed by Governor, becomes Law
The bill will allow groups to offer syringe and needle exchange programs.
H 181 – Definition of “Abused” in the Child Protection Act – Signed by the Governor, becomes Law
The bill expands the definition of “Abused” in the Child Protection Act by replacing “subdural hematoma” with “head injury.”
H 182 – Pharmacist Prescribing – Signed by the Governor, becomes Law
Broadens the ability of pharmacists to prescribe without the specific authorization by the Board of Pharmacy, so long as the practice conforms to the following criteria:
- Does not require a new diagnosis;
- Is for a minor or self-limiting illness;
- Has a CLIA waived test to support a diagnosis, or
- The patient’s health and safety may be threatened if not provided immediately.
H 244 – Naturopathic Medicine – Signed by the Governor, becomes Law
The bill establishes licensing for naturopathic physicians under a subsection of the Board of Medicine allowing them to practice as primary care providers. It distinguished between licensed and non-licensed naturopaths.
S 1099a - Adolescent Residential Treatment – Passed Senate, to House Health and Welfare Committee
The bill seeks a waiver to Department of Health and Welfare rules that prohibit adolescent residential treatment programs for substance abuse. In Idaho, adolescents do not have access to crisis centers or adult treatment programs. This bill would allow centers who segregate adolescents to provide residential drug treatment with parental approval.
H 248 – Occupational Licensing Reform Act – Signed by the Governor, becomes Law
Reduces barriers to licensing, accepts relevant military education and training and expedites licensure for members of the military, their spouses and veterans.
H 116 - Rape Kit Testing – Signed by the Governor, becomes Law
The bill requires the processing of rape kits, clarifies the procurement and retaining of kits and the submission of DNA results to a national database. Sexual assault kits will be processed by the Idaho State Laboratory, DNA data entered by the state and the kits returned to the law enforcement agency for retention of not less than 10 years.
H 64 - Changes to the Complications of Abortion Reporting Law – Sign by Governor, becomes Law
The controversial law was passed in 2018 to require healthcare providers, physicians and nurses, to report on any complications of abortion including divulging patient information. The law also directs the Board of Nursing to take license action against nurses who fail to report. The law is being challenged in federal court as it requires the reporting of confidential patient information protected under federal law. The changes presented by Representative Greg Chaney of Caldwell is meant to address legal concerns by clarifying legislative intent and replacing the requirement to report any complication with a requirement to only report treatments that are, within the medical provider’s judgement, the result of having had an abortion.
HCR 4 - Reject Immunization Rules – Referred to House Ways & Means, no further action
Representative Giddings of White Bird introduced a bill to reject the Department of Health and Welfare Meningitis Immunization rule that requires high school graduates receive the second immunization. The bill has been held in the Ways and Means Committee essentially killing the bill.
The Immunization Rules passed earlier in the session.
H 133 – Immunization Exemptions – Passed House, to Senate Health and Welfare and held
The bill is being held by the Committee Chairman and will not get a hearing. The bill introduced by Representative Giddings would have required daycare facilities and schools to provide immunization exemption forms to parents and guardians.
Religious Exemption to the Child Protection Act
A draft bill was circulated early in the session that would have limited the religious exemption to the Child Protection Act in cases where serious illness, disability or the child’s life is in danger. A bill was never introduced. There will be no action this year to address children who die by not having medical care. A last-minute effort to allow children of parents who refuse treatment for religious reasons to have Medicaid coverage and to seek treatment without parental consent was proposed as an amendment to the Medicaid Expansion bill S 1204. That proposal failed.
H 9 – Physician and PA Licensing – Signed by the Governor, becomes Law
The Medical Practice Act was last updated in 1997. The bill simplifies licensing requirements.
H 12 - Opioid Antagonists – Signed by the Governor, becomes Law
The new law becomes effective in July and will allow access to naloxone to anyone without a prescription. Naloxone is a very safe drug, and this bill will put it in the hands of families and friends of those at risk of opioid overdose.
S 1033 – Notification for Organ Donation – Passed Senate, no action in House
Requires EMS, law enforcement, coroners to notify state communications center upon determining death for the purpose of alerting organ retrieval centers.
H 59 - Age for Organ Donation – Signed by Governor, becomes Law
Lowers the age for organ donation to 15.
HJM 1 – 611 Crisis Hotline – Adopted
Introduced by Representative Caroline Troy, this bill will establish “611” as the Crisis Hotline focused on mental health, domestic violence and suicide.
S 1034a – Oral Chemotherapy – Passed Senate, no action in House
The bill would require insurance coverage for oral chemotherapy the same as IV or injectable chemotherapy. Amended to reset the implementation date to January 1, 2020.
S 1028 - First Responder Workers Compensation Coverage for PTSD – Signed by the Governor, becomes Law
Under current law, PTSD is covered only if it is also associated with physical injury. The bill will allow Workers Compensation coverage for PTSD alone for first responders, EMS, Fire, Law Enforcement.