By now we have all heard the stories. Hardworking Idahoans barely making ends meet, yet unable to qualify for Medicaid assistance — 78,000 of our fellow citizens caught in the health care gap. People getting sicker and sicker because they can’t access basic prescription and health care services to manage chronic conditions. Friends and neighbors forced to wait until something gets so bad that they end up in the emergency room.
Yet a solution exists. Medicaid expansion would allow those in the gap to access health care, save counties millions of dollars in catastrophic care, and boost Idaho’s economy in the process.
The state of Idaho receives federal dollars for education, the INL, transportation, labor, agriculture, homeland security, fire protection and myriad other programs. Yet in the past four years, in the face of continued recommendations to the contrary, the Idaho Legislature has not acted to utilize available federal dollars to help the estimated 78,000 Idahoans in the gap. We are already taxed to pay for Medicaid expansion. The money just isn’t coming back to Idaho; it’s going to other states. Four years of inaction have left hundreds of millions of dollars on the table that could be helping those in the gap while growing the Idaho economy.
Steven Peterson, a clinical assistant professor of Economics for the College of Business and Economics at the University of Idaho, published a study in 2014 titled “The Economic Impacts of Medicaid and Proposed Medicaid Expansion,” and updated the study in 2016.
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Peterson’s updated study estimated that had Medicaid expansion been approved in 2016, it would have resulted in 11,787 new jobs with compensation totaling nearly $439 million. He estimates that those new jobs would have generated $16.2 million in sales tax revenue, in addition to increased property tax and income tax revenues. The study also shows significant savings to both the state and counties resulting from reduced catastrophic medical costs.
At the end of the 2016 legislative session the Senate passed a bill authorizing the director of Health & Welfare to apply for a waiver to allow Idaho to tailor Medicaid expansion to best practices in Idaho. This bill failed in the House. The state of New Hampshire expanded Medicaid in 2015, then proceeded to, based on actual experience and data, apply for a series of waivers to craft a program that works for its state. They have been able to articulate criteria and identify policies that worked and those that proved to be administrative burdens. Most importantly, they have been able to provide health care to their citizens caught in the gap while crafting an efficient state system.
The legislative interim Working Group on Healthcare Alternatives is charged with making recommendations to the full Legislature. Nearly 80,000 of our fellow citizens are suffering needlessly while a solution exists just beyond their grasp. But it is not beyond the grasp of the working group or of the Legislature. Idaho can expand Medicaid now. The Department of Health and Welfare is already redesigning health care delivery through the SHIP grant. Waivers can be carefully analyzed and crafted based on real experience and data. Federal tax dollars paid by Idahoans can be returned to boost the economy and, most importantly, to finally bring a comprehensive solution to those in the gap.
Maryanne Jordan is the Idaho state senator for District 17 and is a member of the legislative working group.