This Idaho senator could save Medicaid expansion and her constituents. She should | Opinion

One of the most important decisions for the future of Idaho’s working poor families and its health care system currently lies in the hands of one woman: Sen. Julie Van Orden, R-Pingree, chair of the Senate Health and Welfare Committee.

On Wednesday, the House narrowly passed House Bill 138, a bill that would almost certainly result in the repeal of Medicaid expansion, which was overwhelmingly passed by Idaho voters by ballot proposition in 2018. It’s been an overwhelming success, helping tens of thousands of low-income Idahoans secure health care, whereas before they were dying of preventable or easily treatable diseases like asthma.

That bill has been communicated to the Senate, where it’s been referred to Van Orden’s committee.

She now has to decide whether it will get a hearing or die in her desk drawer.

She should lock it up and throw away the key to protect the wishes and interests of the people who put her in office.

Maybe it would be better to live in a world where a single committee chair can’t kill a bill. But we don’t live in that world. And until the rules change, this is a power Van Orden and any other chair has the right to exercise.

Van Orden’s District 30, encompassing Bingham and Butte counties, is about as red as it gets. President Donald Trump beat former Vice President Kamala Harris in the most recent election by a 60% margin in Bingham and a 70% margin in Butte. And Van Orden bested her Democratic challenger by similarly wide margins.

That district also has a clear record on the issue of Medicaid expansion. Voters supported it.

It wasn’t by enormous margins, but 2018’s Proposition 2 passed in Bingham and Butte counties combined with just over 52% in favor.

And it’s not hard to see why voters in such a conservative district would nonetheless want to extend assistance with health care to their neighbors.

In Butte County, one of every five families has an income below the poverty level. That’s one of the highest rates in the state, and more than double the state average.

(Don’t be confused by sites listing Butte County as the wealthiest in Idaho. These statistics count income based on the location of the employer, not the employee. Idaho National Laboratory is located in Butte County, but the overwhelming majority of the roughly 6,000 INL workers live in Bonneville, Jefferson and other nearby counties, not in Butte.)

Bingham County’s poverty rate of around 7% is much closer to the state average, but per capita income is still about a third lower than in Ada County.

In short, if you live in Butte or Bingham counties, chances are good you know families who are now or have been protected from bankruptcy by Medicaid expansion.

And the benefits are not only for those who directly qualify for Medicaid expansion.

Lost Rivers Medical Center, the only major center for health services if you live near Arco, like many rural hospitals relies heavily on Medicaid payments to keep its doors open.

As CEO Brad Huerta said last year: “I’m hopeful that as the Legislature meets, if they start looking at scaling back Medicaid, they take a good hard look at what that really means,” said Huerta. “(Expansion) is good for Idaho; it is good for rural communities. You should expand it, frankly, if you care about rural areas.”

That has only grown truer over time. Medicaid expansion was followed by the elimination of the Catastrophic Health Care Fund and reduced reliance on county indigent funds. If there’s a wave of newly uninsured people in Idaho, concentrated in places like Butte County, there will be a wave of uncompensated care at Lost Rivers and similar rural hospitals. Without other means to be paid for that care, such hospitals will have to either make care much more expensive for the patients who can pay or, eventually, close their doors.

Van Orden should do what any good senator should: Work to protect her district. Keep her constituents insured and her hospitals open.

She should deny a hearing to H138.