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Medicaid expansion bill has first hearing with House subcommittee

BISMARCK -- Gov. Jack Dalrymple said he thinks the politics associated with Obamacare should not deter the state from implementing a federally-funded Medicaid expansion, even though lawmakers from his own party say it isn't a popular idea.

The House Appropriations Human Services subcommittee on Friday heard the first testimony in favor of Dalrymple's proposed budget for the Department of Human Services that includes the Medicaid expansion.

Maggie Anderson, interim executive director for Human Services, told the plan that the expansion provision, "has the greatest potential to impact (Human Services) Department programs and services."

The bill, House Bill 1012, would give the department any federal funds received from the Patient Protection and Affordable Care Act passed by Congress in 2010.

The federal funding would provide insurance for individuals under 65, are not disabled, don't have insurance and have an income less than 138 percent of the federal poverty level, Anderson said.

The expansion program would impact many individuals currently paying for care on a sliding fee schedule based off their income, Anderson said.

Committee Chairman Rep. Chet Pollert, R-Carrington said Medicaid expansion "isn't a popular item," but it "will be the Legislature's decision on what we do."

In an interview after the hearing, Dalrymple said the national spotlight on the expansion program and its ties to Obamacare can sometimes make issues seem more difficult, and believes this might be one of them.

"We try to leave the politics out in the hallway when we make these decisions. In the end, it comes down to are you going to allow your people to have additional Medicaid money that comes at no cost to us, or aren't you?" he said. "We're thinking, yes, we should."

Dalrymple said by including the provision in his budget proposal, it simply gives the Department Of Human Services the ability to spend the federal funding if it is needed.

"If the money doesn't show up, it just doesn't get used," he said. "That's far better to not have it in there and have the money show up from the federal government in the middle of the biennium and you're wishing you did have authority to spend it. It's always better to err on the side of allowing it, and then see what happens."

He said members of his staff will continue to testify in favor of keeping the provision if the House Appropriations Committee decides to remove it.

"Our director will be up at the podium and say 'we feel we should have this authorization. If some free money shows up, we can use it.," he said.

Anderson said the federal funds would likely change the collections process at the Human Services Center as it would add more people to the program.

"We ask ourselves, would it diminish access for existing clients or improve with additional revenue?" she said Friday afternoon.

The answer to that question is unknown right now, she said, but plans to provide estimates about the cost of expanding coverage and the number of people the expansion will affect in her testimony in the coming weeks.

Pollert said a lot more information needs to be presented before major action can take place.

"There is a hole there and I am going to want to know that information before it comes to the floor," he said.

The bill is scheduled for work by the sub-committee next week.