Regan v. Denney

437 P.3d 15, 165 Idaho 15
CourtIdaho Supreme Court
DecidedFebruary 5, 2019
DocketDocket No. 46545
StatusPublished
Cited by16 cases

This text of 437 P.3d 15 (Regan v. Denney) is published on Counsel Stack Legal Research, covering Idaho Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Regan v. Denney, 437 P.3d 15, 165 Idaho 15 (Idaho 2019).

Opinions

BURDICK, Chief Justice.

Petitioner Brent Regan asserts that Idaho Code section 56-267, a statute enacted pursuant to the initiative power retained by the people of Idaho in Article III, section 1 of the Idaho Constitution, violates Idaho's Constitution by delegating future lawmaking authority regarding Medicaid expansion to the federal government. Regan requests that this Court declare section 56-267 unconstitutional and also requests that this Court issue a writ of mandamus directing the Secretary of State Lawerence Denney to remove section 56-267 from the Idaho Code. We dismiss *18Regan's petition and deny his request for a writ of mandamus.

I. FACTUAL AND PROCEDURAL BACKGROUND

In the November 6, 2018 election, the Idaho electorate passed a ballot initiative, known as Proposition 2, to expand Medicaid eligibility in Idaho. On November 20, 2018, the Acting Governor issued a proclamation that Proposition 2 had passed, and subsequently the Idaho Code was amended to add section 56-267 which reads 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.

A brief discussion of Medicaid history is helpful to understanding the genesis of Proposition 2. The Medicaid program was established in 1965 to provide medical care to indigent people as well as people " 'whose income and resources are insufficient to meet the costs of necessary medical services' including nursing home care." Stafford v. Idaho Dep't of Health & Welfare , 145 Idaho 530, 533-34, 181 P.3d 456, 459-60 (2008) (quoting Cleary v. Waldman , 167 F.3d 801, 805 (3rd Cir.1999) ).

The Medicaid program is administered by the states on a matching-fund basis, with the lion's share of support coming from the federal government. The states do not get the matching funds without strings. As one might suspect, the states must meet certain requirements in order to obtain the federal funds. Medicaid is a cooperative federal-state venture through with [sic] the states operate programs of their own design. These programs must, however, be consistent with federal standards and regulations.

Id. at 534, 181 P.3d at 460 (citation and quotation marks omitted).

When the Patient Protection and Affordable Care Act (ACA) was enacted by Congress in 2010, it contained a requirement that, in order to keep existing Medicaid funding, states had to expand Medicaid "to cover all individuals under the age of 65 with incomes below 133 percent of the federal poverty line." Nat'l Fed'n of Indep. Bus. v. Sebelius , 567 U.S. 519, 576, 132 S.Ct. 2566, 183 L.Ed.2d 450 (2012) (emphasis in original). This would have significantly changed Medicaid, as the existing "Medicaid program offer[ed] federal funding to States to assist pregnant women, children, needy families, the blind, the elderly, and the disabled in obtaining medical care." Id. at 519, 132 S.Ct. 2566 (citing 42 U.S.C. § 1396d(a) ). Idaho joined with twenty-five other states to challenge the mandatory provision. Id. at 520, 132 S.Ct. 2566. In its Sebelius decision, the U.S. Supreme Court held that the provision in the ACA that required states to expand Medicaid was unconstitutional, but held that states could voluntarily expand Medicaid. Id. at 587, 132 S.Ct. 2566. The ACA also created a system of insurance subsidies for individuals with household incomes of 100 percent to 400 percent of the federal poverty line, which was not affected by the Court's decision in Sebelius . Thus, after the U.S. Supreme Court's ruling in Sebelius struck down the mandatory Medicaid expansion in the ACA, there existed a "Medicaid gap" for people who did not qualify for existing Medicaid, but also did not have an income of at least 100% of the federal poverty level so as to qualify for insurance subsidies. People in the "gap" were left with no affordable healthcare options.

*19Proposition 2, now Idaho Code section 56-267, expands Medicaid eligibility in Idaho to cover Idaho citizens who fall in the "Medicaid gap" by expanding coverage in Idaho to citizens who are under 65 years of age, whose modified adjusted gross income is 133% of the federal poverty level or below, and who are not otherwise eligible for Medicaid coverage under the existing state plan. Section 56-267 directs the Department of Health and Welfare (the Department) to submit the necessary amendments to the state Medicaid plan to the United States Department of Health and Human Services, Centers for Medicare and Medicaid Services. I.C. § 56-267.

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Cite This Page — Counsel Stack

Bluebook (online)
437 P.3d 15, 165 Idaho 15, Counsel Stack Legal Research, https://law.counselstack.com/opinion/regan-v-denney-idaho-2019.