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Experts to health-care workgroup: Exercise fiscal caution, focus on employment

Experts to health-care workgroup: Exercise fiscal caution, focus on employment

Dustin Hurst
June 22, 2016
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June 22, 2016

A legislative workgroup has been tasked with finding health-care solutions for thousands of Idahoans caught in a coverage gap created by Obamacare. Ahead of their meetings, two experts suggest the group focus on employment opportunities and exercise fiscal caution when it makes its policy recommendations.

The 10-member workgroup, announced by Idaho House and Senate leadership last week, will use the summer months to examine myriad health-care options. Among the options are Obamacare’s Medicaid expansion, direct primary care and community-care models.

Christie Herrera, vice president of state affairs and policy fellow for the Florida-based Foundation for Government Accountability, urged Idaho legislators to understand the composition of the gap population and the range of needs.

“It’s important to remember who falls into Idaho’s so-called ‘gap population,’” Herrera told IdahoReporter.com Tuesday. “Sixty-seven percent of Idahoans eligible for Obamacare’s Medicaid expansion are able-bodied adults without a disability, or they don’t have dependents who could keep them from meaningful employment. A third of those who would be eligible don’t work at all, and just 20 percent work full-time, year-round jobs.”

Instead of dumping 78,000 Idahoans without health insurance into the state’s already-growing Medicaid program, Herrera suggested that legislators pursue alternatives outside direct, government welfare.

“The best cure for this population is to get them working again, not put them on taxpayer-funded welfare,” she said.

The Foundation for Government Accountability has been a staunch voice against Medicaid expansion in several states. The group warns that enrollment growth often comes in far above predictions, which causes trouble for already-burdened state budgets.

An FGA report released last April detailed how badly many states missed their expansion enrollment estimates. California, for one, projected it would add just more than 900,000 people to its Medicaid rolls, but instead it gained more than two million as of the report’s release.

Closer to Idaho, Nevada projected it would add 78,000 individuals to the government health-care program. Instead, as of January 2015, that state added 166,393. Like in California, the number of people who signed up for Medicaid expansion in Nevada was more than double original state projections.

Idaho’s Department of Health and Welfare projects that approximately 78,000 Idahoans lack health coverage.

One medical expert, Dr. John Livingston, recently warned against an expansion that swallowing the whole projected Medicaid population. Instead, he suggested, in a blog post for the Idaho Freedom Foundation, that the Gem State find coverage options for those seriously ailing, a smaller population.

“Importantly, of the 78,000 in the gap, it is estimated that 22,000 to 26,000 have chronic diseases,” Livingston wrote last week. “This is the population truly in need of assistance.”

Livingston, a former military doctor and medical practitioner for more than 40 years, wants lawmakers to help Idahoans “most in need.”

In a call Tuesday, Livingston hoped lawmakers will, “Focus their emphasis on the people who are sick and have illnesses and live at the margins.”

The former military doctor also suggested lawmakers require Idaho hospitals, on track to report more than $3.2 billion in combined revenue this year, make independent audits of themselves available to the public each year. That, he said, would help address ballooning health costs.

“If they don’t do that, we have no business giving them anything,” Livingston said.

Coming to a consensus likely won’t come easy. Health-care was a hot topic of the 2016 legislative session, but lawmakers declined to take action.

The Idaho House had voted in 2016 to spend $5 million a year for the next two years on community health clinics. However, an unfriendly Senate amendment, which would have opened the door to Medicaid expansion, caused House members enough consternation that they declined to take a final vote on the plan.

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