When Idaho Gov. Butch Otter signed an executive order blocking the implementation of the Patient Protection and Affordable Care Act (PPACA), referred to by some as Obamacare, it didn’t slam the door completely on the multi-billion federal program. The governor allowed state agencies and employees to ask for his approval on a waiver to follow parts of the program, including accepting federal grants.
So far, Otter has signed off on 10 grants that would let state agencies spend $18.9 million in federal funds from the PPACA. State officials say the money won’t implement the parts of the health reform laws that the governor and lawmakers have publicly scorned, including the individual mandate to buy health insurance, but are for other federal health programs that are part of the law.
“The governor has said before, if folks make a good argument and explain the reasons for it, he’s willing to have his mind and opinion changed,” said Otter’s spokesman, Jon Hanian. “In some cases they were successful; in others they weren’t.” Hanian provided IdahoReporter.com with a list of the waivers approved by the governor.
The biggest waiver approved is the $12.5 million Idaho Ladder to Success Project requested by the College of Southern Idaho (CSI). That grant is intended to improve technical college’s efforts to help students trying to enter the health care, energy and manufacturing job sectors. Idaho State University could also get $1.2 million for a doctor residency program.
Half of the 10 waivers the governor approved were from the Department of Health and Welfare (DHW), which runs Medicaid and other health programs that often rely on both state and federal tax dollars. Approved DHW waivers included money for a media campaign to promote quitting smoking and planning to determine how to help people on Medicaid with chronic illnesses, as well as several grants to help public health efforts.
“I don’t think you can consider tobacco prevention to be health care reform,” said DHW spokesman Tom Shanahan, who said Idaho had received federal funds for similar programs before the reforms were passed. “When you think of health care reform, you think of things that are going to change in the health care industry, and these are things that aren’t really involved in health care reform.”
Otter also rejected one DHW waiver request, for increased Medicaid funding for more community-based personal care services. Those services allow people to live on their own, by paying people to come into their house to help with routine tasks.
“For many people, if they get those services, they don’t have to go to a nursing home,” Shanahan said. Idaho does offer some personal care services to people. The grant would’ve allowed the federal government to pay for more and help more people live on their own, but would’ve required the state to increase its total funding, as well.
“It’s an expansion, and right now we’re not in the business of expanding anything,” Hanian said. “We’re not looking to expand programs at this point, because of the uncertainty, and beyond that, concerns about the spending that we’ve seen in Washington.”
The governor also approved a waiver to let the Idaho Department of Labor continue setting up a information system for primary care health jobs. That grants provides $125,000 in federal funds.
The Department of Adminstration received two grants. One allows the state to have its health plan for state workers be grandfathered into the federal health reforms. That requires the state to maintain some of the benefits, but not follow all the reforms to insurance plans. The second waiver would allow the department to receive more than $2 million in reimbursements for any state workers who might retire early and aren’t eligible for Medicare who might stay on an insurance plan provided by the state.
Hanian said the waivers the governor approved don’t put into place any new national health care provisions and that Idaho has been working on state-based health reforms for years. “We were doing this after we got into office,” Hanian said. “Obamacare is something that came along afterwards.”