State Politics

Butch Otter on his endorsement: Medicaid expansion ‘was the only game left in town’

Gov. Otter and Medicaid expansion: He was in 6 weeks before vote

Gov. Butch Otter says the people of Idaho exercised their right to petition the government and "I'm behind the people." He spoke Nov. 9, 2018, 3 days after Idahoans voted to expand Medicaid.
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Gov. Butch Otter says the people of Idaho exercised their right to petition the government and "I'm behind the people." He spoke Nov. 9, 2018, 3 days after Idahoans voted to expand Medicaid.

Gov. Butch Otter said Friday that his endorsement of Medicaid expansion ahead of this week’s election was in line with years of advocating for expanding government health insurance access in some form.

And, he said, he doesn’t view his late endorsement as late. Idahoans for Healthcare — the “yes” campaign for Proposition 2 — announced Otter’s support on Oct. 30, one week before Election Day.

“If the question is, did I flip? No. No, I didn’t,” he told the Statesman shortly after a lunch speech to the Boise Metro Chamber.

Otter instead pointed to his years of pitching Medicaid expansion alternatives to the Legislature, and to his early agreement with House and Senate leaders not to act on Medicaid expansion through an executive order. He also noted his work to create a state-run health insurance exchange under the Affordable Care Act; at the time, he made national news as a rare Republican governor pursuing that course.

“As you’ll recall, that insurance exchange was a heavy lift, and I ended up with a pretty tough primary a couple of years after that because I created a state insurance exchange,” Otter said.

In the intervening years, Otter and his department heads tried to develop “an Idaho solution” — limited steps that might be more palatable to lawmakers and still help Idahoans who can’t afford health insurance.

He and Gov.-elect Brad Little also raised eyebrows early this year with an executive order seeking to allow insurance plans that drop some aspects of the ACA. National experts deemed it likely illegal, and while negotiations with the federal government continue, that effort has not succeeded so far.

“A few legislators that voted against my dual waiver [one of the alternate proposals] last year ... have called and said we made a mistake, we should have accepted that,” Otter said.

Otter and his wife, Lori, both signed the Proposition 2 petition, he said. A few weeks before Tuesday’s election, they reached out to Idahoans for Healthcare and offered their support, he said.

“This was the only game left in town” after the legislative failures, he said. A citizen-run initiative appealed to him, he added. “And so I’m behind the people. Let’s petition our government.”

Otter’s endorsement still surprised many, especially again on the national level.

Jefferson Kemper is the campaign manager for Idahoans for Healthcare. He said in a Friday phone interview that the Otters contacted the campaign “saying, ‘We’ve been supporters of closing the gap the whole time and we would like to help if we can.’ ”

Including the couple in ads and other outreach took some time, he said. But in his view, the timing one week before Election Day worked well, even in a year with heavy early voting.

“Gov. Otter coming out in support of full Medicaid expansion let voters know that this is a fiscally conservative choice, that voting for medicaid expansion is the right thing for our state,” Kemper said. “... I think it made a huge impact for Gov. Otter to weigh in at the time that he did, and I hope that it will reinforce the commitment that Gov.-elect Brad Little has made, which is to implement and support the will of the people on this issue.”

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