The Patient Protection and Affordable Care Act (Obamacare) contained many provisions. One of these expanded Medicaid to individuals earning up to 138 percent of the federal poverty level. The federal government would initially pick up the entire cost, but eventually Idaho would cover 10 percent. Idaho has rejected the expansion, and in my view, this has hurt all Idahoans and our state.
Approximately two-thirds of those eligible for Medicaid under the expansion are in the workforce but do not have employer-provided health insurance. These individuals are exposed to financial ruin from illness, along with disability and preventable death.
Medicaid expansion would benefit all Idahoans in a number of ways. First, hospitals could hire additional staff, and across Idaho, hospitals are among the biggest and best employers in town. Second, as clinics, hospitals and local governments lose less money to uncompensated medical care, citizens will experience better medical services. Third, as a physician educator in Idaho, I do not think we can currently accommodate the massive growth of medical education envisioned by the Idaho College of Osteopathic Medicine. Medicaid expansion will help fill this gap by funding patient care and health care providers. Fourth, when patients are able to receive necessary and appropriate treatment for addiction and mental illness, there is less of a burden on expensive government institutions like prisons and state-run mental hospitals. Finally, when previously uninsured patients receive health insurance, they often have expensive unmet health care needs. This increases everyone’s insurance premiums. Medicaid expansion would diminish this problem.
Medicaid expansion would also benefit Idaho. According to the Idaho Workgroup on Medicaid Expansion, Idaho would gain $9.24 billion in federal funding over 10 years. This additional funding would also create 16,000 jobs, and nearly 80,000 Idahoans would gain access to health insurance. The changes facilitated by expanding Medicaid would grow tax revenues by approximately $615 million over 10 years. This would allow Idaho to fund other priorities, like schools, roads and tax cuts.
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Like many Idahoans, my brother Joel did not have health insurance for much of his adult life. He always worked and made ends meet by cutting wood, fixing vehicles and eating wild game. He struggled with health issues, but cost (amplified by lack of health insurance) kept him from seeking medical attention. In the midst of a particular low point, Joel took his life in December 2006, at the age of 31. I will never know if his death could have been prevented, but modern medicine has a lot to offer people with physical and mental illness. By accepting the Medicaid expansion, Idaho can provide people like my brother with health insurance.
There are plenty of arguments for and against Obamacare. However, President Donald Trump and the Republicans in Congress have been unable to repeal and replace Obamacare — which remains the law of the land, irrespective of Idaho’s decision about Medicaid expansion. What we can and should do is accept federal funding to provide health insurance to fellow Idahoans.
Dr. Bob McKie is a physician in Boise.