According to Bill Dentzer, “turning down Medicaid expansion dollars means Idahoans are rejecting funds they have already paid into the health care system via their taxes. Idaho is effectively subsidizing other states that have expanded Medicaid.”
This is simply not accurate. Expanding Medicaid is incremental spending. If Idaho chooses not to expand Medicaid, then the money does not go to other states; it simply does not get spent. As an entitlement, current Medicaid is governed by the rules on “mandatory” federal spending. It is one of the reasons the federal deficit is growing again. The annual federal deficit is circa $500 billion, so incremental spending has nothing to do with the taxes we pay today. Taxes don’t fully cover the federal government’s current spending, so how can incremental spending be covered or related to current taxes? It can’t.
Future taxes from Idahoans will cover some portion of the interest on the debt that is accumulated from Medicaid expansion. Since the accumulated federal debt is more than $19 trillion with no path to a balanced budget, future taxes will cover interest payments for incremental spending and not the spending itself. That is the math, not the politics.
Fred Birnbaum, Boise
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