State Politics

What would the Senate’s latest health care plan have done in Idaho?

Rep. Mike Simpson on health politics: 'We just have differences of opinion'

Speaking in May 2017 at the Idaho Healthcare Summit, U.S. Rep. Mike Simpson said health care reform is at a turning point: either moving to far less federal control, or a single-payer system.
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Speaking in May 2017 at the Idaho Healthcare Summit, U.S. Rep. Mike Simpson said health care reform is at a turning point: either moving to far less federal control, or a single-payer system.

Idaho would get more federal funding, at least for a handful of years, under the latest Republican health reform proposal.

Analyses by the Kaiser Family Foundation and the Centers for Medicare and Medicaid Services found the proposal would be a short-term windfall for Idaho.

This and other states that chose not to expand Medicaid under the Affordable Care Act would initially benefit from how the bill would redistribute federal funding.

The Kaiser analysis put Idaho’s cumulative gain by 2026 at about 27 percent, or $1.2 billion. CMS looked at the difference in individual years, with the proposal giving Idaho just 9 percent more money in 2020, or $38 million, and climbing up to an 87 percent increase in 2026, or $514 million.

The boost would only be temporary. Starting in 2027, Idaho would start to see severe cuts in federal dollars.

And the Cassidy-Graham plan to dismantle the Affordable Care Act and replace it with capped block grants likely would tank the state’s nascent plan to insure many of Idaho’s working poor while stabilizing insurance costs for its middle class.

Idaho’s top health and insurance agencies sent letters to Gov. Butch Otter last week listing several changes Congress would need to make to the Cassidy-Graham proposal in order for Idaho’s plan to function. Those include excluding pharmacy costs from the per-capita cap and making sure block grants keep up with medical inflation after 2026.

The Republican proposal looked destined to follow its predecessors to the grave Friday afternoon, after Republican Sen. John McCain of Arizona said he would vote against it.

But some components of the plan — such as block grants and funding caps — aren’t novel ideas. They go back decades in federal politics and could show up again in future GOP plans to repeal the ACA.

The Kaiser and federal projections contrast with a long-running Obamacare argument. Proponents of Medicaid expansion say that Idaho’s decision not to expand it in the early days of the ACA cost this state a significant amount of federal money and left some residents in a “gap” — too poor for health insurance subsidies, too rich for Medicaid.

Audrey Dutton: 208-377-6448, @IDS_Audrey

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