Not long ago, the proponents of a state insurance exchange were telling us that if the state created an insurance exchange, Idaho would be able to formulate a unique, customizable “Idaho solution” to our Obamacare woes.
Then a mere one day after the vote, the same insurance exchange proponents began pitching lawmakers to abandon Idaho’s own system of care for the poor in favor of the enlargement of the federal Medicaid program. Indeed, on some news websites, pro-insurance exchange ads have gone away, replaced with pro-Medicaid expansion ads.
Supporters of Big Government think, with the exchange debate concluded to their liking, that they’ve baited a big Idaho fish and they’re ready to reel us in.
Equally unfortunate is that on Friday, House and Senate Health and Welfare committees held a meeting to hear the benefits of Medicaid expansion. At no point were opponents given a chance to speak. The testimony in support of Medicaid expansion was so effusive that Moscow Democratic Sen. Dan Schmidt quickly made a motion to forward the bill on for consideration by the full House. House Health and Welfare Chairman Fred Wood pointed out that the bill wasn’t properly before the committee, the public hearing hadn’t taken place yet and ruled that the motion was out of order.
Medicaid expansion is a serious public policy commitment that deserves more than a one-sided debate in the last week (or so) of the legislative session. Proponents describe Medicaid expansion as a panacea that will save money and offer care to people who don’t have it.
But other research puts that argument in dispute. According to the Heritage Foundation, Idaho taxpayers will expend $149 million more through 2022 on the enlarged Medicaid system. And it’s quite possible the costs will be even more than that.
Expanding Medicaid has other problems. Medicaid hasn’t helped make people healthier and it hasn’t cut down on costs. Expansion will lead to worse patient outcomes, problems with access, and health care over-utilization. And Medicaid expansion won't save taxpayer dollars; at best, Medicaid expansion—funded nearly entirely by a broke federal government that has to borrow 40 cents for every dollar it spends—merely transfers the cost of health care to our kids and grandkids, who are already stuck with a growing debt-laden bill from a severely bloated federal government.
Therefore, if Idaho expands Medicaid just to transfer today's health care costs to future generations of Idahoans and Americans, it would be cruel, self-serving and shortsighted.
Instead of expanding Medicaid, the state should reform the costly county indigent program. The state would do well to incentivize charitable delivery programs like the free clinic in Canyon County. That clinic, started a few years ago by a Bible study group, is saving county taxpayers half a million dollars a year operating just one night a week. Instead of dealing with federal bureaucrats, state and local bureaucrats, clinic patients get to see real doctors and real nurses, volunteers who do a great job simply practicing medicine largely uninhibited by government.
Those are real solutions that deserve consideration. Expanding Medicaid is not a solution, but a looming disaster for our state.
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