When the U.S. Supreme Court upheld the health care reform law earlier this summer, states faced several decisions.
Among them: The Patient Protection and Affordable Care Act requires states to decide whether or not they will expand their Medicaid eligibility requirements.
What states were not given was information on how to make the best decision.
Anticipating a need for better data on a possible Medicaid expansion, the Idaho Department of Health and Welfare requested an analysis of newly eligible Medicaid individuals in April.
The report, by the Leavitt Partners consulting firm, was released this week just in time to be distributed to Gov. Butch Otters Medicaid expansion work group before it meets later this month. The 15-member work group has been asked to evaluate the impact of expanding Medicaid and to make a recommendations to the governor by Nov. 1.
According to the report, close to 111,500 additional Idahoans would qualify for Medicaid if the state expanded its eligibility. About 17,300 would be from Ada County and 14,600 would be from Canyon County.
Idahos Medicaid federal-state partnership offers medical insurance to almost 235,000 low-income people. Nearly 70 percent of those enrolled are children from low-income families. Medicaid also covers people with disabilities, low-income women who are pregnant and low-income elderly people.
Expanding Idahos eligibility requirements would provide insurance coverage for low-income adults up to 138 percent below the federal poverty line. Currently, Idaho allows adults who are not disabled or elderly to qualify for Medicaid only if they have children and an income less than 20 percent of the poverty level. For a family of four, that level is about $4,500 a year.
The report also said as many as 47,000 Idahoans now served by four other state programs could shift to Medicaid. They include 35,000 people receiving care from community health centers, 6,000 people who rely on the catastrophic health care program of the state and counties, and 4,300 people receiving mental health services.
Under the health care reform law, the federal government would pay 100 percent of the states expansion costs for three years. By 2020, the federal funding would bre cut to 90 percent.
According to the report, Idaho doesnt face a deadline to notify the federal government when it will begin a Medicaid expansion.
Overall, the report urged Idaho leaders to wait to make a final decision until the federal government releases more guidelines on Medicaid expansion, which should occur after the November election.
If Idaho does choose to expand, the report recommended implementing changes in 2014. That would provide eligibility for three years of full federal funding while also allowing Idaho to opt out of the program after 2016.
The work group will meet Sept. 27 in Boise. Live audio will be available at www.idahoptv.org/leglive.
Statesman reporter Audrey Dutton contributed.