The people have spoken on Medicaid expansion. Let’s get it done.

The Idaho Constitution flatly declares: “All political power is inherent in the people.” Those people established a government of elected representatives to carry out regular public business. However, they wisely reserved the right to initiate and pass laws when their representatives balk at carrying out the public’s wishes.

We witnessed the people properly taking the law into their own hands last November. For years, public polling indicated that the people wanted to expand the state’s Medicaid program to cover people who earned too much to qualify for coverage, but too little to get assistance under the Affordable Care Act. About 60,000 working folks fall into that gap.

After the Legislature failed year after year to carry out the will of the people, Idaho voters stepped up in record numbers to pass a people’s initiative expanding Medicaid. It is now the law of our state and deserves to be implemented in the form approved by a substantial majority of voters.

Much to his credit, Governor Brad Little has pledged to honor the decision of Idaho voters to expand the Medicaid program. He had promised to do so in his campaign and has just said he will seek implementation of the law in an “Idaho way.” In this case, an Idaho way would be exactly as set out in the measure approved by a 61% vote of Idahoans who went to the polls.

There are those who mean to sabotage the initiated law. The Idaho Freedom Foundation (IFF) has challenged the law in court, trying to frustrate the will of the people. The Attorney General has pointed out the substantial flaws in their case and the challenge is bound to fail (although I have no inside information as to how the Supreme Court might rule).

The IFF will likely turn to the Legislature in hopes of amending the new law to death. Rep. Fred Wood, an M.D. who chairs the House Health and Welfare Committee, says the law should be implemented just as approved by a landslide vote of the people. After all, the people hold ultimate political power in our fair state. They had a lengthy campaign to hear and consider both sides of the issue and decide how to vote.

There has been talk of adding work reporting requirements to the Medicaid program, even though there does not appear to be a problem with the current recipients, and the people in the gap are obviously working. Medicaid is an efficient medical program that keeps low-income people healthy at a reasonable cost to the public. Why complicate it with bureaucratic regulations?

The work requirements are likely violative of federal law and have been subject to court challenges for that reason in other states. A court challenge in Idaho would probably just result in the state having to shell out attorney fees for another flawed law.

A work requirement has been a headache in Arkansas, resulting in qualified workers being denied benefits because of complicated reporting requirements. The respected Kaiser Family Foundation reported on the merits of the issue in Implications of Work Requirements: What Does the Data Say? For those interested, it can be found at: www.kff.org/medicaid/issue-brief/implications-of-work-requirements-in-medicaid-what-does-the-data-say/.

We should assume that the people of Idaho are smart enough to exercise their ultimate policy-making power with wisdom and compassion. They should not be second-guessed by their elected representatives. Those voters who swarmed to the polls in record numbers voted both for a large Republican majority in the Legislature and a qualification-free Medicaid expansion. Should their decision be challenged on either count? The Legislature’s boss has spoken so it should follow those orders.

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