Boise State University recently released its Idaho Public Policy Survey, conducted Dec. 3-8, 2016, finding 70.8 percent of Idahoans favor gubernatorial and legislative action to provide the 78,000 gap citizens access to quality health care. Support for closing the gap has increased about 10 percent from the last poll.
Yet the best the Idaho Legislature has proposed this session is to take $10 million from the state’s Millenium fund for primary care services, less than the $30 million Gov. Butch Otter proposed last year. This equates to approximately $125 per gap individual — not enough to cover recommended screenings and an annual exam, as former Idaho Rep. John Rusche pointed out.
How would the money be allocated? Sponsor Rep. Fred Wood, R-Burley, stated, “Basically on a first-come, first-served basis. As I understand it, that’s the way it’s going to have to work.” So get in line, Idaho poor.
Both The New York Times and The Washington Post recently ridiculed Idaho’s feeble attempts to skirt Medicaid expansion. The Post’s Feb. 9 headline read, “Republicans in Idaho tried to design a better plan than Obamacare — and failed.”
Time may be running out — forever — for Idaho to provide comprehensive coverage for the gap population. On Feb. 16 House Speaker Paul Ryan outlined the draconian plan to replace the Affordable Care Act. Medicaid would be replaced by block grants to the states.
While the details aren’t clear, block grant money would likely be allocated to states based on present federal dollars. The 19 states like Idaho who have not expanded Medicaid would likely lose forever.
Idaho has been here before. As Bryan Clark pointed out in the Post Register recently, Idaho had very poor welfare funding in 1996 when welfare was turned into a block grant. So while New York receives $2,600 per child, Idaho receives $400. And poverty in Idaho has increased from 13 percent of citizens below federal poverty level to 16 percent, deep poverty from less than 4 percent to more than 6 percent. It’s income inequality by state — and fixed forever in federal allocations.
It’s becoming clearer that Medicaid expansion improves a state’s financial picture. Adding 78,000 to Idaho’s pool will greatly enhance our long-term Medicaid funding, even if the percentage per enrollee reimbursement were to drop from 90 percent to 50 percent, as Ryan has proposed. It won’t drop that much — Republican governors who have seen their citizens achieve health coverage won’t stand for it.
Meantime, 78,000 Idahoans continue to suffer and die — nearly one per day, with unfathomable suffering by those affected. These are our fellow citizens, the majority of whom work, the rest predominately severely disabled, and we must not forget their plight. This is not how we treat each other as Idahoans.
So when the Legislature is debating $10 million for health care for the poor, tell them no — no way are we going to stand for that mistreatment of Idaho citizens. For $122 million the Legislature can fully expand Medicaid this session. Missing this opportunity may lock us in forever as a second-class state. Seventy-one percent of Idahoans support Medicaid expansion. We must make our voices heard.
Dr. Kenneth Krell is an intensivist at Eastern Idaho Regional Medical Center. He can be reached at firstname.lastname@example.org.