Idaho taxpayers getting a good deal since voters approved Medicaid expansion | Opinion

Medicaid expansion is turning out to be a good deal for Idaho.

It’s estimated that Medicaid expansion will save taxpayers about $10 million next year.

The Idaho Department of Health and Welfare is requesting about $67 million in state general fund dollars associated with Medicaid expansion. Without Medicaid expansion, though, costs to state and local taxpayers would be about $77.7 million because of costs associated with such things as more expensive emergency room visits, mental health and drug use disorders, and costs to the state catastrophic health fund and local indigent care funds.

Further, hospitals reported spending $42 million less on charity care and $61 million less on bad debt, according to Juliet Charron, administrator of the division of Medicaid with the Department of Health and Welfare, who on Monday updated state legislators on Medicaid expansion.

Idaho voters in 2018 approved expanding Medicaid to Idaho residents who made too much money to qualify for regular Medicaid under the Affordable Care Act but made not enough money to qualify for subsidies on the state health insurance exchange.

Medicaid expansion took effect in January 2020, just months before the COVID-19 pandemic hit.

About 145,000 Idahoans are enrolled as part of Medicaid expansion, which provides coverage to non-disabled adults with an annual household income of up to 138% of the federal poverty level.

Medicaid expansion patients receive preventative care, can go see a primary care doctor and specialists and get preventative screenings, such as colonoscopies and mammograms. That keeps them out of emergency rooms and out of more expensive health care situations.

Charron shared the story of a woman named Carol in Nampa, a home health care worker ironically without health insurance, who said, “Medicaid saved my life,” because she was able to get precancerous cells surgically removed.

Medicaid is a hot topic this year, not just because of Medicaid expansion but also because of the dramatic growth in the overall Medicaid budget.

The request this year is $4.6 billion, a 16% increase, with most of that paid through the federal government.

Legislators are correct to be concerned about the rising cost of the program — but not for the reason some legislators may be thinking.

“As I’ve visited people on Medicaid and people with disabilities, they sit on their couch and watch TV and just get depressed and eat lousy food, and their life stinks,” Rep. Clay Handy said last week during a budget hearing.

Handy’s comments illustrate an underlying attitude some Republican lawmakers seem to have about Medicaid in general, which is why they’re so opposed to Medicaid expansion.

But more than 80% of Idahoans benefiting from Medicaid expansion have reported income, Charron said. And disabled Idahoans aren’t part of Medicaid expansion. They’re covered by a different, older segment of the Medicaid program.

It’s important to look at costs, not because of the “lazy welfare recipient” myth, as expressed by Handy, but because we need to ensure that Medicaid is being administered correctly, and money is being spent on the people who need it most — people like Carol in Nampa.

Legislators and Health and Welfare officials are rightly looking for cost controls because they’re also looking for ways to increase reimbursements for doctors who accept Medicaid, so that the patients who truly need it are getting the care they need.

But some things are becoming clear, now two years into Medicaid expansion: Idaho is getting a good deal with Medicaid expansion, Idaho taxpayers are saving money and health outcomes are improving for thousands of Idahoans, which helps the economy and arguably is saving lives.

This is no time to throw the baby out with the bathwater.

Statesman editorials are the unsigned opinion of the Idaho Statesman’s editorial board. Board members are opinion editor Scott McIntosh, opinion writer Bryan Clark, editor Chadd Cripe, newsroom editors Dana Oland and Jim Keyser and community members Johanna Jones and Maryanne Jordan.