Would you be in favor of expanding health care coverage to 150,000 Idahoans and at the same time providing cost savings to Idaho, improving Idaho’s economy, creating 16,000 new jobs, lowering health care costs, and producing healthier Idahoans? Such an opportunity is presented to Idaho now.
As a member of Gov. Butch Otter’s task force, which voted 15-0 in favor of this expansion, here are eight reasons why:
1. It saves Idaho money. The expansion of Medicaid to 150,000 people will cost Idaho $284 million over the next 10 years. However, the federal government’s payment program for this expansion will bring in $290 million to the state over that time. Idaho stands to gain $6 million by expanding Medicaid. Conversely, there are 70,000 Idahoans who already meet the expanded eligibility requirements and their coverage will cost the state hundreds of millions of additional dollars without the benefit of enhanced federal payment if we don’t do this.
2. Positive economic impact. The economic impact on Idaho is impressive as the dollars introduced into the economy creates 16,000 new jobs and increases both personal income and state and local tax revenues. Economists estimate Idaho will gain approximately $616 million in sales, property and income taxes by expanding Medicaid.
3. It stops cost shifting. If Idaho chooses not to expand Medicaid, 80,000 Idahoans remain uninsured. When the uninsured get sick and can’t pay their medical bills there is a cost shift to private insurance companies and increased premium rates for the insured. In short, Idaho citizens will pay increased costs on our own insurance if expansion is not done. That is exactly what is happening now. Oftentimes, employers are faced with the hard decision of increasing health insurance premiums to their employees vs. giving pay raises to those same employees.
4. Loss of future jobs. New businesses will not seek Idaho as a place to locate their company because of the higher than average insurance premiums secondary to this cost-shifting phenomena. This is not good for Idaho’s growth or economy.
5. Paying for other states’ Medicaid expansion. If Idaho doesn’t expand Medicaid, we will still pay taxes. These tax dollars will flow out of our state to surrounding states that have expanded Medicaid to their citizens. We will become a bill payer for Medicaid expansion in neighboring states.
6. Medicaid delivery redesign. The work group saw an opportunity to help Idahoans become more responsible and accountable for their health care. By aligning incentives that promote positive health behavior we can lower health care costs and help promote healthier Idahoans.
7. Helping our counties. Currently, the counties and state medical indigent fund pay for qualifying uninsured people who default on medical bills that exceed $10,000. Expansion would reduce state and county indigent health care expenses by 90 percent and would save the counties and state $290 million over 10 years. This results in less county and state taxes and stops this cost shift.
8. Produce healthier Idahoans. Multiple studies demonstrate two things help improve health care outcomes the most:
1) A usual source of care.
2) Some sort of health care coverage.
Timely access to needed care (wellness, prevention, and chronic disease management) decreases higher cost downstream, ER utilization and hospitalization. Providing coverage and timely access to 150,000 Idahoans stops people living sicker and dying younger.
It is much more expensive to take care of sick people than it is healthy people. We have an opportunity to help align Idaho’s economy, cost savings, financial incentives, cost shifting and promoting a healthier Idaho. Now is the time for the Idaho Legislature to vote yes on expanding Medicaid for Idaho.
Ted Epperly, M.D., is program director and CEO of Family Medicine Residency of Idaho.
