For 4 years, 78,000 Idahoans in the health care gap have waited for a solution. Two task forces have recommended Medicaid expansion with no action by the legislature. The adoption of the Affordable Care Act would have provided 100% funding for expansion for the first four years. We missed out. We were told we needed to wait until we have a new president. We have one.
We’ve been told we have to wait for the federal proposal to decide what we do next. We have the federal proposal. It retains the option for states to expand Medicaid, preserves Medicaid in its current form until at least 2020, and funding is still available at a 90% match rate. The cost for the Idaho match would be equal to the amount the state is now paying for catastrophic care.
In the Senate, an amendment to allow Medicaid expansion was voted down in favor of a small primary care program that will only serve a few people with certain conditions. It will also strip funding from Project Filter and many other prevention programs designed to keep folks healthy. Ironic.
Let’s talk for a minute about the discussion of whether or not to accept available federal dollars for Medicaid expansion (which are really our tax dollars coming back to Idaho). Idaho receives federal dollars for education, the Idaho National Laboratory (INL), transportation, labor, agriculture, homeland security, fire protection, military installations and a myriad of other programs. Yet in the past four years, in the face of continued recommendations to the contrary the legislature has not acted to utilize available federal dollars to help the 78,000 Idahoans in the gap. I don’t know about you, but I know how much my husband and I pay in federal taxes and I would love nothing more than to be able to direct some of those dollars home to help my fellow Idahoans. We are already taxed to pay for Medicaid expansion. The money just isn’t coming back to Idaho; it’s going to other states. Four years of inaction have left hundreds of millions of dollars on the table that could be growing the Idaho economy.
Idaho’s citizens are suffering unnecessarily. Take southeastern Idaho for example: In Jefferson County, roughly 7% of the population falls in to the Medicaid gap; Bingham County has about 6.1% of the population without any health coverage; Bonneville County has 4.9%, Madison County, 4.6%.
Some of the biggest employers in the state are health care providers. St. Luke’s, St. Al’s, Kootenai Medical Center and Portneuf Medical Center, in addition Idaho’s community health centers will be able to add jobs that will contribute to the economy. In rural communities hospitals are often the area’s largest employer and have benefited across the country from Medicaid expansion.
What will it take for the legislature to address this issue? Idahoans caught in the gap are bankrupted by health care bills. They are forced to seek help at emergency rooms; the most expensive care possible. They are going without crucial medications that could manage serious conditions. This leads to a limited ability to work and provide for themselves and their families.
Regardless of political consideration, any recommendation should provide the most economic benefit to the state, and more importantly the most comprehensive solution for the estimated 78,000 Idahoans in the gap. If it doesn’t get done in this session the governor should call a special session to solve this problem. 78,000 Idahoans can’t wait any longer.