The 2017 legislative session is moving along, with week seven having just ended. This week I will look at reactions to the White House’s proposal for replacement of the Affordable Care Act (ACA), and look at outcomes from the latest JFAC committee meeting here at home. I will follow up on a couple of bills I’ve been tracking and, again, encourage all readers to look at the new advocacy opportunity presented by Close the Gap Idaho (as well as other advocacy and involvement opportunities) listed below. As always, if you have questions, comments, or suggestions regarding issues or items that you would like to see followed here, please feel free to contact me at: tiffenystees.policyintern@gmail.com.

On the National Level

Reactions from health policy experts continue to flow in, in response to the GOP’s proposal for repeal and replacement of the ACA. Analysts say that this plan would “substantially cut funding for states in providing free insurance to low-income adults through Medicaid [and] would change how tax credits are distributed by giving all Americans not covered through work a flat credit by age, regardless of income” (read source material here). The replacement plan heavily emphasizes tax credits and health savings accounts (HSAs) which disproportionately benefit those who need it the least: middle to higher income Americans. To read more about HSAs and their implications to our economy and lower income people, go here. Read about Idaho’s HSA proposed legislation for state employees (S1046) here, or read the full bill located in the IPHA Bill Tracker below.

There have been additional suggestions for making health care plans more affordable to the public in the wake of an ACA repeal. One such proposal involves trimming the so-called fat from what insurers are required to offer. GOP leaders suggest that “shrinking the list of services that insurers are required to offer in individual and small group plans would reduce costs and increase flexibility.” One service, specifically, came to light during Seema Verma’s confirmation hearing two weeks ago (Verma is slated to run the Centers for Medicare & Medicaid Services in the Trump administration). Namely, Verma and others propose that coverage for maternity services should be optional in health plans as a potential cost cutting measure. Currently, the ACA requires that this and other vital areas of healthcare coverage are required to be offered by insurers. Changes under Tom Price (and potentially Verma’s) leadership may serve to weaken those requirements. Read source material for this and previous paragraph here. Read about the ten essential benefits under the ACA that may suffer cuts here.

On the State Level

The legislative hearing scheduled to cover H0160, the “Health Care Assistance Program” bill, was canceled (by the committee chair) on Monday, February 20^th. I will continue to monitor HB160’s progress, and welcome all those who are doing the same to keep me in your informational loop (email address listed above). For easy to implement guidelines in contacting Idaho lawmakers regarding health care coverage issues facing our state, Close the Gap Idaho has an excellent template and instructions here. Use it, or pass it on.

The Joint Finance-Appropriations Committee met on February 20^th, and unanimously approved  current budget year changes including: “a $5 million reduction in general funds to the Catastrophic Fund, because of fewer cases than expected in fiscal year 2016; a nearly $400,000 reduction in general funds for non-emergency transportation under Medicaid, due to the state’s new, lower-cost contract with Veyo; and an additional $128,600 to the Department of Health & Welfare’s Physical Health Services division for an expanded access program that’s providing a limited number of Idaho children with intractable epilepsy with the experimental drug Epidiolex, which contains CBD oil, or cannabidiol, a derivative of marijuana.” Read source material (Russell’s full article) here.

 Bills in Focus

H0146: Update

On Tuesday, February 21^st, the House Judiciary, Rules and Administration Committee voted to advance H0146, (Rep. Melissa Wintrow, D-Boise), out of committee with a “Do Pass” recommendation. H0146 was read a second time on February 24, 2017, and a third reading has been filed. To recap from last week’s update, H0146 proposes to “codify standards for sexual assault victims’ access to medical examinations,” and, “sets standards for sexual assault evidence retention and preservation.” I had the opportunity to watch Representative Wintrow present on this bill, and watched testimony given in support of the same. There was overwhelming forensic, and legal support for H0146. Law enforcement officials testified to the necessity of preserving evidentiary rape kits for the proposed 55 year time period in order to give victims the opportunity to come forward at later dates, and also to increase the likelihood of catching “serial rapists,” tying them back to earlier crimes as well.  

Success! HCR003: Idaho Caregiver Alliance (ICA) Update

HCR003, a concurrent resolution designed to raise public awareness of the importance of Idaho caregivers, and recognize their enormous contributions to the State of Idaho, was unanimously passed in the Senate on Tuesday, February 21^st. Senator Fred Martin (R) spoke to the resolution on a personal level, having had experience with caregiving himself. The Senator noted that it was a piece of legislation that reflected the “honor[ing of] thy father and thy mother,” citing biblical text to reflect how many Idahoans will or do provide care for their parents (and other loved ones). The “Next Steps” piece of the ICA’s Idaho’s Lifespan Family Caregiver Action Plan will now bring to bear as the value and necessity of the population it impacts has been officially recognized. Read The Plan in its entirety here. A link to HCR003 is provided in the Bill Tracker below.

H0091 Update

H0091, a bill requiring all providers and all immunizations (except for flu shots) be recorded in the state’s Immunization Reminder Information System (IRIS), failed in the House on February 23^rd. The ostensible purpose of this bill was to ensure that a child would not inadvertently receive duplicate immunizations, but was noted by opponents to also extend to adults. As it stands, and will now remain, those who do not want their information shared or reported have the ability to opt out. Read what those opposed to this bill had to say during testimony here, and the perspective of others who were opposed here. Read about the importance of accurate immunization record keeping here

Advocacy spotlight:

A chance to advocate on behalf of Tobacco 21, an initiative strongly supported by the IPHA, is at hand. A (tentative) full hearing in Senate State Affairs Committee (Room WW55, Garden Level), is scheduled for March 3^rd at 8 a.m. Talking points for this tentative public hearing have been provided by the American Lung Association, Idaho and can be found here. Read more about what’s happening in the Legislature with this here.

Upcoming Advocacy Days & Involvement Opportunities

February 27^th: Alzheimer's Association Idaho, the Capitol. Be visible and wear purple to show your support on their advocacy day!

March 3rd: Tobacco 21 (tentative) full hearing at 8 a.m. Room WW55, Garden Level of the Capitol.

March 9th: Close the Gap Idaho invites the public to attend "A Plan not a Delay Procession" Thursday, March 9th from 12:30 to 1:30 p.m. on the First Floor Rotunda at the State Capitol. Please wear WHITE to show your support, and to add visual impact to this advocacy opportunity.

IPHA Bill Tracker

Bill No.	Description	Last Action
S1003	Nurse emeritus licenses; licensure renewal & reinstatement	02/24/2017 H-Passed; title approved to Senate
S1004	Board of Nursing member raise in compensation	02/24/2017 Reported enrolled; signed by President; to H for Speaker sig.
S1009	DEQ; crop residue burning	02/24/2017 Passed House; title approved to Senate
S1013	Marijuana/drug paraphernalia repeal	02/16/2017 H-Read 1st time; referred to JRA
S1024	Child protective act/definition revised	02/22/2017 H-Read 1st time; referred to JRA
S1031	Veterans transport fund grant program	02/09/2017 Read 1st time; referred to State Affairs
S1037	Dentists licensing provisions revised	02/24/2017 H-Passed; title approved to Senate
S1038	Dentistry Board/emergency proceedings	02/09/2017 Rep. out of committee; to 14th Order for amendment
S1046	Health savings acct/high deductible plan	02/23/2017 S-Read 2nd time; filed for 3rd reading
S1050	Immunizations/exemption forms	02/08/2017 S-Reported printed; referred to Health & Welfare
S1058	Telehealth access; cost coverage	02/09/2017 Reported printed; referred to Commerce & Human Resources
S1060	Health care/cytomegalovirus	02/22/2017 S-Read 2nd time; filed for 3rd reading
S1081	Immunization assessment bd/sunset revised	02/23/2017 H-Referred to Health & Welfare
S1082	Community primary care program	02/13/2017 S- Reported printed; referred to Health & Welfare
H0002	Pharmacists reciprocal licensing	2/17/2017 H-Reported signed by Governor on this date
H0003	Pharma/tuberculin protein products	2/17/2017 H-Reported signed by Governor on this date
H0004	Pharmacists, tobacco cessation products	2/17/2017 H-Reported signed by Governor on this date
H0005	Controlled substances, opioids	2/17/2017 H-Reported signed by Governor on this date
H0006	Controlled substances	02/14/2017 H-Reported signed by Governor on this date
H0007	Massage therapists; change “establishment to school”	02/24/2017 S-Read 2nd time; filed for a 3rd reading
H0008	Massage therapists; institute criminal background checks	02/23/2017 H-Returned from Senate failed; filed in office of Chief Clerk
H0010	Chiropractic practice; licensure	02/22/2017 H-Reported signed by Governor on this date
H0011	Optometrists; licensure/provisions & revisions	02/23/2017 S-Reported out of committee; 14th order for amendment
H0020	Vehicles; hybrid/plug-in fee reduction	02/23/2017 H-Delivered to Governor on this date at 11:10 a.m.
H0025	Tobacco permits, terminology	02/17/2017 Reported signed by Governor on this date
H0038	Mental health, cite ref added	02/24/2017 S-Read 2nd time; filed for 3rd reading
H0039	Medicaid; H&W agreements	01/24/2017 Reported printed and referred to Health & Welfare
H0040	Hosp, mentally ill, release notice	01/24/2017 Reported printed and referred to Health & Welfare
H0041	Individuals w/ disabilities/ABLE accts	02/23/2017 S-Read 2nd time; filed for 3rd reading
H0042	Behavioral health, council board	01/24/2017 Reported printed and referred to Health & Welfare
H0043	Med. assistance/eligibility/emotional disturbance	02/22/2017 S-Read 2nd time; filed for 3rd reading
H0044	Secure treatment facility act	01/24/2017 Reported printed and referred to Health & Welfare
H0045	Dieticians/licensing revised	02/06/2017 U.C. to be returned to Health & Welfare Committee
H0062	Youth mental health; conversion	01/27/2017 Reported printed and referred to Health & Welfare
H0080	Public Health Districts/Funding/bd of trustees	02/01/2017 Reported printed and referred to Health & Welfare
H0081	Health care, J-1 visa waiver program	02/23/2017 S-Introduced; read 1st time; referred to Health & Welfare
H0091	Immunization register/pro license board	02/23/2017 H-Failed; filed in office of Chief Clerk
H0115	Physicians, license background checks	02/23/2017 S-Introduced; read 1st time; referred to Health & Welfare
H0128	Medicaid; payment agreements	02/23/2017 S-Introduced; read 1st time; referred to Health & Welfare
H0146	Sexual assault evidence; med exam	02/24/2017 H-U.C. to hold place on 3rd read. calendar 1 legislative day
H0160	Health care assistance program	02/15/2017 Reported printed and referred to Health & Welfare
H0191	Pharmacy/prescriptions authorization	02/17/2017 H-Reported printed and referred to Health & Welfare
HCR003	Lifespan Family Caregiver Action Plan	02/24/2017 Senate – signed by President; returned to House