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2018 Idaho Proposition 2

What is the 2018 Idaho Proposition 2?

2018 Idaho Proposition 2 is an approved ballot initiative that was included on the 2018 General Election ballot on November 6^th, 2018. This Ballot Initiative was approved and qualified to be included for voting on July 17^th, 2018 through campaigning and petitioning for signatures to acquire the necessary support of the voting Idaho population to be included for state-wide voting through the 2018 General Election ballot. This initiative moved to expand Medicaid to persons who did not previously qualify. Proposition 2 would expand Medicaid coverage to persons under the age of 65 if their income is below 133% of the Federal Poverty Line (FPL) and are unable to gain medical insurance or coverage through other means.

National Overview of Medicaid Expansion Initiatives

Campaigning and Petitioning

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Within the campaigning and petitioning portion to gain access to this proposition being listed on the election ballot, there were many officials and organizations that supported this Medicare expansion and worked to help gain the necessary support to allow this topic to be added onto the 2018 General Election voting Ballot in Idaho. There were two major committees that supported Proposition 2 and played a large role within the campaigning and petitioning to get enough support to warrant Proposition 2 onto the 2018 General Election Ballot were the Idahoans for Healthcare and Reclaim Idaho. There were also many persons and organizations that did not support Proposition 2.The primary committee that opposed Proposition 2 being added onto the ballot was Work, Not ObamaCare PAC. The list for donor contributors, supporters, and opposers from Ballotpedia is given below:

Supporters

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The two major committees in support of Proposition 2 were the Idahoans for Healthcare and Reclaim Idaho. The breakdown of their contributions and expenditures is listed below:

Committees in support of Idaho Proposition 2, the Medicaid Expansion Initiative Supporting committees Cash contributions In-kind services Cash expenditures Idahoans for Healthcare $1,615,293.70 $50,549.99 $1,604,659.81 Reclaim Idaho $112,834.43 $3,995.47 $110,371.48 Total $1,728,128.13 $54,545.46 $1,715,031.29

Totals in support Total raised: $1,782,673.59 Total spent: $1,769,576.75

Top donors

The top five donors including businesses and organizations in support of this initiative are listed below:

Top Donors in Support of Idaho Proposition 2 in 2018
Donor	Cash	In-kind	Total
The Fairness Project	$400,000.00	$30,522.21	$430,522.21
Saint Alphonsus Regional Medical Center	$250,000.00	$0.00	$250,000.00
St Luke's Health System	$250,000.00	$0.00	$250,000.00
Idaho Hospital Association	$200,000.00	$0.00	$200,000.00
Susie and A.J. Balukoff	$100,000.00	$0.00	$100,000.00
Idaho Medical Association	$48,769.97	$0.00	$48,769.97

Among the major committees, businesses and organizations there were also many officials and other organizations in which the initiative gained support. These entities are listed below:

Officials

• Gov. Butch Otter (R)
• Paulette Jordan (D), 2018 gubernatorial candidate
• Christy Perry (R-11B)

Former officials

• Boise School District Board Member A.J. Balukoff (D)

Organizations

• Our Revolution
• Idaho Medical Association
• Idaho chapter of the American Heart Association
• American Lung Association
• The Idaho Sheriffs Association
• Idaho Education Association
• Idaho School Boards Association

Businesses

• Chobani
• Clif Bar

The information above was taken from Ballotopedia and can be reviewed here.

Opposition

Work, not Obamacare PAC was primarily funded through direct contributors and supporting contributions from the businesses and organizations such as the Regan Properties LLC and the Idaho Freedom Foundation.

The top five donors, including businesses and organizations in support of the opposition to this initiative are listed below:

Donor	Cash	In-kind	Total
Daniel Brockett	$15,000.00	$0.00	$15,000.00
Doyle Beck	$10,000.0	$0.00	$10,000.00
Regan Properties LLC	$10,000.00	$0.00	$10,000.00
Idaho Freedom Foundation	$0.00	$3,136.47	$3,136.47
Jon Christianson	$5,000.00	$0.00	$5,000.00

The breakdown of direct contributors are as follows:

Itemized Contributions from Personal Contributors

Contributor	Date	Amount
Daniel Brockett	9/4/18	$5,000.00
Daniel Pinkerton	9/17/18	$1,000.00
Donald Brandt	9/21/18	$1,000.00
Doyle Beck	9/21/18	$10,000.00
Ed Johnson	9/26/18	$2,000.00
Burke Hanks	9/26/18	$300.00
Karey D. Hanks	9/26/18	$200.00
Philip Bradley	9/27/18	$1,000.00
Steve Vick	9/27/18	$500.00
Bryan Smith	9/28/18	$2,500.00

The financial information stating contributors and spending for Work, not ObamaCare for more detailed information is here.

Verbiage

The verbiage included on the 2018 General Election Ballot read as follows:

Short Ballot Title                   

"AN INITIATIVE TO PROVIDE THAT THE STATE SHALL AMEND ITS STATE PLAN TO EXPAND MEDICAID ELIGIBILITY TO CERTAIN PERSONS."

Long Ballot Title                    

"RELATING TO MEDICAID; AMENDING CHAPTER 2, TITLE 56, IDAHO CODE, BY THE ADDITION OF A NEW SECTION 56-267, IDAHO CODE, TO PROVIDE THAT THE STATE SHALL AMEND ITS STATE PLAN TO EXPAND MEDICAID ELIGIBILITY TO CERTAIN PERSONS AND TO PROVIDE THAT THE DEPARTMENT OF HEALTH AND WELFARE IS REQUIRED AND AUTHORIZED TO TAKE ALL ACTIONS NECESSARY TO IMPLEMENT THE PROVISIONS OF THIS SECTION; AND AMENDING SECTION 56-262, IDAHO CODE, TO PROVIDE A CORRECT CODE REFERENCE."

Full Text:        

"Be It Enacted by the Legislature of the State of Idaho:

SECTION 1. That Chapter 2, Title 56, Idaho Code, be, and the same is hereby amended by the addition thereto of a NEW SECTION, to be known and designated as Section 56-267, Idaho Code, and to read as follows:

56-267. MEDICAID ELIGIBILITY EXPANSION. (1) Notwithstanding any provision of law or federal waiver to the contrary, the state shall amend its state plan to expand Medicaid eligibility to include those persons under sixty-five (65) years of age whose modified adjusted gross income is one hundred thirty-three percent (133%) of the federal poverty level or below and who are not otherwise eligible for any other coverage under the state plan, in accordance with sections 1902(a)(10)(A)(i)(VIII) and 1902(e)(14) of the Social Security Act.

(2) No later than 90 days after approval of this act, the department shall submit any necessary state plan amendments to the United States Department of Health and Human Services, Centers for Medicare and Medicaid Services to implement the provisions of this section. The department is required and authorized to take all actions necessary to implement the provisions of this section as soon as practicable."

Voting

This initiative gained enough support through the voting within the General Election Ballot period that Proposition 2 was approved through the November 6th, 2018 General Election Ballot. The voting statistics and outcomes from this voting session are detailed below.

The overall voting in regard to Idaho Proposition 2 within the 2018 General Election were as follows:

Idaho Proposition 2
Result	Votes	Percentage
Yes	365,107	60.6%
No	237,567	39.4%

Statewide Voting Statistics
Total Number Registered Voters at Cutoff: 839,406

Number Election Day Registrants: 78,284

Total Number of Registered Voters: 917,612

Number of Ballots Cast: 612,536

% of Registered Voters that Voted: 66.8%

Proposition 2 - Medicaid Expansion Voting Results

Yes Votes: Total: 365,107 Plurality: 127,540 Percentage: 60.6%

No Votes: Total: 237,567 Percentage: 39.4%

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Alteration

This initiative was later modified to include requirements for Medicaid recipients to meet further qualifications to gain eligibility for the expanded program through the establishment of Senate Bill 1204 . The official legislation in regards to this Senate Bill can be found here.

This alteration added requirements to ensure working hours, education hours, volunteerism, or qualification in programs such was TANF or SNAP to gain access the the expanded Medicaid benefits. The Legislative Alteration verbiage is listed below:

“ Legislative alteration:

Senate Bill 1204 was passed in the state legislature on April 5, 2019, and signed by the governor on April 9, 2019. SB 1204 was designed to require Medicaid recipients to do the following:

1.Work at least 20 hours per week or earn wages equal to or greater than the federal minimum wage ($7.25 per hour as of 2019) for 20 hours per week or participate;

2. Participate in a work training program for 20 hours per week;

3. Be enrolled at least half-time in postsecondary education or other education program;

4. Satisfy the work requirements with a combination of working, volunteering,

or participating in a work program for 20 hours per week; or

5. Comply with the requirements of the work programs under the temporary assistance for needy families (TANF)

or supplemental nutrition assistance program (SNAP).

SB 1204 includes some exemptions for the work requirement.”

State and National Financing and Cost Information

Cost

The estimated amount for Medicaid expansion in Idaho is 105 million dollars. Many studies have found that in total expansion states have saved around 6.2 billion dollars in uncompensated care between 2013 to 2015.

Funding

The total amount raised for Idaho's proposition 2 was $1,782,673.5. The top five donors in support for Proposition 2 was, The Fairness Project, Saint Aphonsus Regional Medical Center, St. Luke's Health System, Idaho Hospital Association, Susie and A.J. Balukoff.

State Budget

Idaho's state budget for Medicaid is 27.8 percent.

National Budget

The nations budget for Medicaid is estimated at $344.4 billion.

Implementation

Legal Cases

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There has been one lawsuit in regards to Proposition 2, since it was approved through the 2018 General Election. This lawsuit was: Brent Regan v. Idaho Secretary of State Lawerence Denney and was filed within the Idaho Supreme Court. The Plaintiff, Brent Regan, made the argument that through the passing of Proposition 2, the initiative violates the constitutional right of the state and the Medicaid expansion within Idaho delegates too much power to the Federal Government. This case was found to be ruled in favor of the Defendant, Idaho Secretary of State Lawerence Denney. The court ruled that Regan's concerns were based within the hypothetical and the judiciary branch was not the appropriate mediary at this time. The courts stated within their case report conclusion section that the voting results have proven the voice of the people within the State and it is now within the hands of the legislative branch of government. The case that Regan has proposed is not a constitutional issue and has been brought to the attention of the courts prematurely.

Current Status

Since the events of Proposition 2 being passed, there are currently 36 states in which Medicaid has been expanded within due to voter initiatives in each state. Within 2019, there are still 14 states which have not passed medicare expansion initiatives. Through the Medicaid expansion efforts it is reported to have increased yearly coverage for persons earning up to 138% of the Federal Poverty Level.

Medicaid Expansion Nationwide as of November 2018

Additional Sources

Reclaim Idaho: https://www.reclaimidaho.org/

Idahoans for Healthcare Information: https://www.idmed.org/idaho/assets/files/News/IFH_FAQ.pdf
Senate Bill 1204 official legislation bill: https://legislature.idaho.gov/wp-content/uploads/sessioninfo/2019/legislation/S1204E2.pdf