2016 Idaho Legislature

2016 IDAHO LEGISLATURE

UPDATE

March 21, 2016 through March 25, 2016

Throughout the 2016 Idaho Legislative Session, Nurse Leaders of Idaho and the Idaho Nurses Association provide periodic updates on legislation and activities of interest to nurses, especially in the area of healthcare policy.

Friday, the last day of the legislative session, the House failed to pass one final piece of legislation that could have closed the coverage “gap” for 78,000 Idaho adults who make less than 100% of federal poverty. Although the Senate passed HB 644, which would have directed the Department of Health and Welfare to apply for a waiver and start the process of covering the gap, the House failed to do so and adjourned with no action, and no solution for another year.

Although the outcome is disappointing, your efforts have brought to light the needs for health coverage for all Idahoans.

An important CALL TO ACTION is to let your legislators know how you feel about the failure to take action this year to address healthcare coverage for the gap. This is an important issue that should be considered in the upcoming Primary Election on May 17th and when selecting your legislative representatives in November.

Week 11 – sine die

The Idaho Senate adjourned for the year late Thursday. The House adjourned Friday afternoon after considering the bill to extend healthcare coverage for the Gap. Both Houses have been working double time this week to process the vast number of bills, each one of which is heard by both the House and Senate. It has been a wild ride for Healthcare Coverage for those in the Gap. Every day has been filled with surprises, high highs and low lows. However, the three Nursing bills have progressed unscathed this week.

Healthcare Coverage for the Gap

Thursday last week, two proposals were to be introduced in the House Health and Welfare Committee, however Chairman Wood postponed consideration until Monday morning as work was underway in the Majority Caucus on a new bill. One of the proposals was to create an interim committee that could work through the issues over the summer and bring healthcare coverage legislation next session. The other was for a temporary two-year $5M/year grant to community health clinics to deliver primary care to the Gap population and $400K to provide additional data on Gap needs. Late Thursday and Friday morning revealed some details about a new proposal coming from Republican House members. The new bill being drafted would outline specific details of the Idaho plan, “with guardrails,” and authorize the Department of Health and Welfare to develop and submit the waiver request to CMS for approval. The plan would then come back to the legislature for sign-off next year and implementation in 2017. The new proposal also included the grants to Community Health Centers.

Over the weekend drafts of the new bill, “the Affordable Care Waiver Act “were circulated, but when Monday morning came, Chairman Wood unexpectedly cancelled the Committee meeting signaling dissection in the Caucus. Republicans require a majority of the Caucus for a bill to be introduced. A hearing was called for early Tuesday morning. Only the two previous resolutions were on the agenda, one for the interim committee and the other for the grants. As these were print hearings for bill introduction, there was no public testimony. There was however quite a bit of discussion by Committee members. The vote for both bills was 8-3 with one republican dissenting. The bills were sent directly to the floor Tuesday afternoon, again with much discussion, both bills passed the House.

Wednesday morning, Representative Vander Woude of Nampa presented the bills to the Senate Health and Welfare Committee who were very critical of the limited efforts of the House to address the real issue of the coverage for the Gap. The Committee unanimously voted down the creation of an interim committee and barely approved HB 644 sending it to the Senate for amendment. When the bill came to the Senate floor Thursday afternoon the entire language of the original House bill 644 had been substituted for the language from the “Accountable Care Waiver Act” that was drafted but never considered by the House. The new HB 644a would

 Authorize the Director of the Department of Health and Welfare to submit the waiver application to the federal Department of Health and Human Services, CMS, for approval;

 Address Medicaid Managed Care for those under 100% of the federal poverty line;

 Have a “drop-dead” date of June 30, 2018;

 Have an “Emergency” clause making the law effective upon adjournment of this legislature;

 Creates a committee made up of four members of the House and four members of the Senate, three republicans and one democrat from each chamber, to work with the Director Health and Welfare on the waiver and program design;

 Return to the 2017 legislative session for approval of the plan;

 Create the Grant Program for Community Health Centers and Rural Clinics, $5M for two years (already approved by JFAC from pre-millennium fund income) and $400K for data collection, and

 Keep all options on the table to develop a unique Idaho plan.

The Senate passed HB 644a 27 – 8. With the waiver authorization it would jump-start the development of the plan to be reconsidered next year. The Senate then adjourned for the year, eliminating any further Senate/House conferences for reconsideration. The House pushed into Friday morning to consider the amended bill H644a, but did pass the finance authorization bill for the $5 grant. The grant would only become effective if the H644a were to pass.

Friday morning on the House floor, Representative Vander Woude made a motion to reject the amended bill as it came back to the House substantially changed from what had been proposed. The floor vote was 55 – 12 with 3 abstaining. The effect of the vote is to kill any movement this year on solving health insurance coverage for the working poor who are in the gap between Medicaid eligibility and subsidy under the Healthcare Exchange.

Nursing Bills

The two compact bills, one to update and renew the interstate licensure compact for registered nurses and licensed practical nurses and the other a new interstate compact for advanced practice nurses, passed both houses and were signed by the Governor this week. They will become law July 1st. However, the APRN compact will only become effective after 10 states have signed on.

The Definition of Nursing bill was approved by the House this week and signed by the Governor Friday. It also becomes effective July 1st. The new definition of nursing practice updates the Nurse Practice Act to better reflect the practice of nursing across the many areas of current practice.

 Nurse Licensure Compact S1251

http://www.legislature.idaho.gov/legislation/2016/S1251.htm

 Advanced Practice Nurse Licensure Compact S1250 http://www.legislature.idaho.gov/legislation/2016/S1250.htm

 Definition of Nursing Practice – Revised S1382

https://www.legislature.idaho.gov/legislation/2016/S1382.htm

A recap of all of the nursing related bills will be included in a final legislative wrap-up along with other bills of interest related to healthcare early next week.