The Patient Protection and Affordable Care Act, commonly referred to as Obamacare, as a consequence of its health insurance mandate, will push as many as 12,000 Idahoans onto Medicaid at a cost to taxpayers of more than $31 million next year, according to projections from the state Department of Health and Welfare (DHW).

The agency included the $31 million figure in its Medicaid budget recommendation to Gov. Butch Otter for the spending year that starts July 1, 2013. The amount is included in a Medicaid budget that is expected to grow by nearly $200 million, or about 12 percent, to $2.15 billion, according to the budget estimates, even if the state Legislature chooses not to expand Medicaid as allowed under President Barack Obama's health care reform law.

DHW spokesman Tom Shanahan said the state expects up to 12,300 people to enroll in Medicaid to avoid being fined by the federal government for failing to have insurance.

"If people must either have insurance or pay a fine, we assume they will enroll rather than pay a penalty," said Shanahan. Of the $31 million, more than $8 million would come from the state general fund; the rest would come through federal funding, according to the agency's budget request, which has yet to be considered by Otter.

The remaining expected increases in Medicaid are the result of an increased number of people joining the Medicaid rolls and anticipated intensified utilization of the program.

Idaho State Rep. Steven Thayn, R-Emmett, currently sits on the House Health and Welfare Committee and is not supportive of the department's request. "It is time to freeze the Medicaid budget," he said. The Emmett representative is seeking a spot in the Idaho Senate in the November election.

Thayn did offer some suggestions for potential alternatives to the proposed increase. "The current Medicaid entitlement system is an open-ended system and it is time we look at other options that create a culture of productivity," he said. "What our goal should be is to improve services, decrease costs and increase individual choices. We need to look at a different approach to the Medicaid system. We need to talk about lifetime limits and limits as a percentage of state budgets.”

The lawmaker added, “What we should be trying to do is increase services by engaging people in contributing to the system rather than just becoming recipients. There is a whole slew of things we can do, but just simply to say we are going to spend more money is unacceptable."

Gov. Otter's press secretary, Jon Hanian, told IdahoReporter.com that the governor's office does not comment regarding budget proposals until the State of the State address in January, but added that the governor will evaluate the state's "economic outlook, unemployment and revenue stream" before making his recommendation.

For the current fiscal year, the agency requested a 10 percent increase in the Medicaid budget and the governor recommended a 9.5 percent increase. The state Legislature, however, approved just less than a 6 percent increase.