Idaho hires former Utah governor's firm to study Medicaid expansion

Published: July 17, 2012 

Gov. Butch Otter hasn't made up his mind yet on whether Idaho should add tens of thousands of low-income residents to Medicaid. But he's hired a consulting team to help him figure it out.

Leavitt Partners was hired in May under a $99,000 contract to draft a report on Idaho's possible Medicaid expansion, according to Tom Shanahan, a spokesman for the Idaho Department of Health and Welfare. The report is due in early September, he said.

The expansion would broaden Medicaid eligibility to all people within 133 percent of the poverty line — income of about $14,856 for a single person with no children, or about $30,657 for a family of four — starting in 2014. Idaho currently offers Medicaid to low-income children and pregnant women, and to specific groups such as disabled adults.

The expansion is one goal of the federal Affordable Care Act that was upheld by the U.S. Supreme Court last month.

An expansion would add at least 80,000 people to Idaho's Medicaid rolls, according to estimates used by the state. Many of them would be people who now get care from community health centers and other safety-net medical providers.

Idaho can choose to deny Medicaid to all of its poorest adults. If Idaho does expand its program, the federal government initially must foot the entire bill for new patients, then 90 percent of the bill in later years. However, some Republicans in the Idaho Legislature worry about a bait-and-switch where Idaho gets stuck with a much larger share of the costs.

The federal government currently covers more than two-thirds of Idaho's Medicaid costs. The federal match rate for Medicaid is determined by a state's relative wealth or poverty. Idaho tends to get more Medicaid money from the federal government than most other states.

To predict how a Medicaid expansion could affect Idaho, the consultants from Leavitt Partners will use information gathered from states that already cover low-income adults, Shanahan said. They'll look at how often those adults seek medical care, what kind of medical care they need, how old they are, whether they have expensive chronic conditions and other information.

Leavitt Partners was founded by Michael O. Leavitt, former governor of Utah and Health and Human Services Secretary under President George W. Bush. The consulting firm doubled its staff in one year to accommodate a spike in demand, such as from states wanting guidance on the health care reform law, according to a June 2011 report by Politico.

Shanahan said the report is meant to help Otter's Medicaid-expansion task force. Otter appointed the task force last week. He also appointed a group to study whether Idaho should create its own health insurance exchange, a marketplace for people and companies to buy insurance under the Affordable Care Act.

Audrey Dutton: 377-6448

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