Birnbaum letter: Medicaid hearing

Following the recent Medicaid hearing at the Capitol, a number of contradictory reports surfaced concerning the savings gained by expanding Medicaid.

A year ago Health and Welfare Director Dick Armstrong told the Legislature that his hybrid “Healthy Idaho” Medicaid expansion would save the state $173 million over 10 years. A year later, actuarial firm Milliman updated the study and determined that same plan would cost Idaho $187 million over the next 10 years. That’s a $360 million swing.

The delay is not the primary cause as the year one savings were $65 million, so the delay accounts for less than 20 percent of the shift. The changes that account for the other 80 percent: a 15 percent estimated enrollment bump, and lower state and county catastrophic and indigent health care costs.

The proponents are attempting to shift the debate pretending the net state costs don’t matter because of the federal matching dollars. This assumes that the match can be maintained at the 90 percent or higher rate indefinitely.

Medicaid expansion proponents believe we should ignore net state cost increases, take federal money and become even more dependent on a federal government that is $19 trillion in debt.

This story was originally published February 17, 2016 at 6:33 PM with the headline "Birnbaum letter: Medicaid hearing."