Idaho was set to accept as much as $19 million in federal cash linked to the health care overhaul as state agencies take advantage of waiver provisions that help them skirt Gov. C.L. “Butch” Otter’s executive order aimed at blocking them from taking some of the money.
Idaho is among states suing over the federal law. Otter’s order came after the end of the 2011 Legislature to underscore his official objections to some of the provisions passed by Congress, including to eventually force residents to buy health insurance come 2014 — or be fined.
But the Republican governor has now signed at least 10 waivers to his order, saying programs that sought a reprieve made sense, were part of existing state programs or didn’t further the law’s objectionable aspects that he’s trying to block from taking effect.
“The governor has always been clear, if someone wants to change his mind, he is open to letting them try,” Jon Hanian, Otter’s spokesman, said July 19. “But he has also indicated that before they launch into a sales pitch, they better do their homework and be able to back up their reasons. Obviously in the case of these approved waivers, they did.”
Under the waivers, for instance, the College of Southern Idaho could get $12.5 million for a project to help create education programs at Idaho’s six regional technical colleges. Those would train people who have lost jobs due to foreign competition for new careers in the energy, manufacturing and health care.
Idaho State University is due to get $1.2 million to support for one of its two physician residency programs to help train family doctors, and another $642,404 for a physicians’ assistants program that seeks to meet the medical needs of underserved areas of the state, particularly Hispanic speaking communities.
“The funding does not implement new national health care provisions, but is intended to sustain the development of new family doctors in the state,” according to Idaho State University’s waiver request.
The issue of how to handle money linked to the Patient Protection and Affordable Care Act, as the insurance overhaul is officially known, vexed the most recent Idaho Legislature.
Case in point: Lawmakers initially objected to the Department of Insurance’s $10 million budget for the fiscal year 2012 until the agency removed plans to accept $2.5 million from the federal government to help develop insurance exchanges that are part of the heath care overhaul.
Among the waivers now granted by Otter, the Department of Health and Welfare received six, including for a smoking cessation campaign, for a plan create health homes for chronic illness sufferers who are the most expensive Medicaid clients, and $785,000 to boost the public health laboratory’s ability to identify and respond to disease clusters.
Tom Shanahan, an agency spokesman, said July 19 the waivers allow his agency to continue several programs that had little to do with the federal health care reforms, but were included in the funding that passed along with that bill when President Barack Obama signed it in March 2010.
For instance, the public health laboratory had already gotten $304,000 for its effort to tackle disease clusters prior to Otter’s executive order.
And Idaho has been getting federal funding to help health care providers adopt best practices for treating chronic diseases associated with diabetes, obesity, strokes and arthritis since 2008, but the funds were included in the health care reform bill.
Not being able to get the waiver would have left Idaho without the opportunity to receive more than $1.7 million over the next three years, Shanahan said.
“It really would have dramatic impact on many of our programs that really aren’t health care reform related,” Shanahan said.
Just one request by Shanahan’s agency was denied, so far, for increased federal funding for Medicaid that would have allowed Health and Welfare to expand home and community based services to some low-income residents who don’t qualify for those services now.
Hanian said the governor viewed that program as an expansion of Medicaid, something he doesn’t support.