BOISE, Idaho — A small group of Idaho lawmakers examining how to provide medical care to the estimated 78,000 Idahoans without health coverage remains split on a solution, with some members repeating the same opposition to accepting federal funding that has doomed prior attempts.

The nine-member working group was formed as part of House Speaker Scott Bedke’s promise that the Legislature will address the Medicaid gap during the 2017 legislative session.

His Republican-dominated chamber refused to consider a last-minute expansion plan earlier this year.

Sen. Maryanne Jordan, a Democrat from Boise, urged the group to expand Medicaid — the federal health care program designed to cover the poor — so the state can provide the most comprehensive coverage to vulnerable citizens.

Once the Medicaid gap is addressed, the state could pursue designing a Medicaid waiver — a popular option to allow states more flexibility to manage the Medicaid program, she said.

“We’ve all heard from every corner of the state about support for Medicaid expansion,” said Jordan, one of two Democrats on the working group. “If this committee, and by extension the Legislature, is to recommend something less than a comprehensive solution, I feel like we will be letting our citizens down.”

Several Republican committee members countered that Idaho should experiment with its own solution without relying on the federal government. Concerns over growing health care costs and the federal deficit have kept many conservative legislators from signing off on a standard Medicaid expansion option.

“If we’re ever interested in doing something different … we have to do it first,” said Sen. Steven Thayne, R-Emmett. “We can always come back if that’s not successful.”

Many committee members praised the work of an Idaho Falls doctor for helping keep health costs low. Jim Brooks, who has owned a family practice for 13 years, was one of the few medical professionals to oppose Medicaid expansion in his testimony to the panel.

Brooks does not accept health insurance from his patients and requires payment after each appointment. By offering low fees, Brooks says his collection rate was “101 percent” in 2015.

Patients are encouraged to request help from family or use credit cards to cover his fees. Brooks added that he’s also seen patients fly out to Mexico for major surgeries at medical practices that also take payment upfront.

“Most doctors have not considered running their practice this way,” he said.

Republican Sen. Marv Hagedorn, co-chair of the committee, praised the doctor’s model but cautioned the committee that their model must apply to the “here and now.”

The group will meet again in September.