Russ Fulcher on Medicaid expansion, health care

GUEST OPINION: RUSS FULCHER

March 29, 2014 

Russ Fulcher

One of the main reasons I'm running for governor is because Gov. Butch Otter helped Idaho become the only Republican-controlled state in the country to implement the president's health care law. By putting in place an Obamacare insurance exchange, Idaho is helping cement Obamacare in place. I respectfully disagree with this decision. And while the governor contends his decision is a conservative triumph, you will note that no conservative organization anywhere in the country agrees with Otter's decision. Quite the contrary - they have all advised against it.

Still, I believe Idaho can and should lead when it comes to making health care more affordable and accessible.

Unlike my opponent, who equivocates on the question of Medicaid expansion, I do not support it. Here's why: Medicaid forces everyone into the same cookie-cutter bureaucratic-driven health care system. This raises the cost of health care, while preventing patients from being in charge. Medicaid is well known to be a broken system, wasting millions of dollars. Expanding it will only make matters worse.

The real question is not whether or not to expand Medicaid. The real question is: "What is the best way to bring affordable, quality health care to people with low incomes?" To achieve this, we can do several things: First, let's bring competition to the current Medicaid system. Participants should be able to choose from several customized plans offered by health insurers, hospitals, clinics, and doctor networks alike. These reforms, implemented in states like Florida, have been shown to cut costs and improve patient care.

Second, let's expand charity care in Idaho. Idaho has some 13 charity care clinics that provide health care services for free. Staffed with volunteers who work tirelessly, these clinics are saving taxpayers money and taking pressure off county budgets by helping people to get more regular care. Canyon County Community Clinic, for example, saved Canyon County's hospitals $630,000 last year through preventive care of diabetes patients. Better care at less cost. This is a winning combination.

Direct primary care is another option that Idaho can emphasize. This allows a person to buy a "membership" in a physician's practice, thus avoiding the need to buy an Obamacare policy through the health exchange. Instead, the patient pays a flat fee to a physician, who then provides a range of agreed-upon services. The patient can pay cash or through a Health Savings Account.

Finally, Idaho should eliminate many of its insurance restrictions. Before Obamacare made it cool to tell people what their insurance plans had to have, Idaho already had numerous restrictions and requirements. And if you wanted to find an insurance product that met your need, perhaps from another state, you couldn't, because that is illegal in Idaho. Current Idaho law makes shopping around for insurance illegal. Changing our laws to eliminate marketplace restrictions will lower prices, increase competition and promote consumer choices.

In my view, the insurance exchange was an unnecessary state-run federal program. The benefits and coverage levels are based on federal rules. The plans must meet federal rules.

We don't need a health exchange, Medicaid expansion or anything else tied to Obamacare. Idaho can lead the nation in health care choice, competition, and security. The federal government brings nothing but rules, red tape, and costs. They create uncertainty for Idahoans, making our people wonder if they'll keep their insurance, and, if they do, what it will cost. Idahoans want choice, responsibility, incentives, and improvement in their health care. They deserve nothing less.

Fulcher is an Idaho state senator who represents Meridian.

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