Idaho Politics Weekly story adds confusion to the Medicaid expansion debate

Fred Birnbaum Articles

One reason why there is acrimony related to Medicaid expansion here in Idaho is that supporters have put out so much false and misleading information – and continue to do so.

If we can’t agree on a simple set of facts around true costs and coverage, we will not come up with the appropriate policy solution.

Here’s another case study: Chuck Malloy of Idaho Politics Weekly provided an overview of Sen. Marv Hagedorn’s position on Medicaid expansion in Idaho. Given that Hagedorn recently co-chaired a legislative working group on this topic, it was a great opportunity to add clarity to the discussion.

Unfortunately, the article only added confusion.

The senator advocated that Idaho sign onto Medicaid expansion for two years then shift to a state-funded, primary care system. Hagedorn backed away from this position after Republican Donald Trump won the White House in November and suggested he wants to unwind the Affordable Care Act (ACA).

Further, even if no changes were made to the ACA, what results would you see in two years that would prompt the Legislature to do an about-face and suddenly shift to a state-funded program as the senator suggested?

Plus, Medicaid expansion requires that recipients be provided the “10 essential benefits” as required by the ACA. Why would people who signed up for Medicaid suddenly want to be put into a state program that provides only primary care?

Hagedorn said, “The numbers show that when people have access to healthcare, it costs them and it costs the state less money.” Actually the numbers do not show that.

For the first time in US history, in 2016, healthcare spending surpassed 18 percent of GDP. According to ACA supporters, more than 20 million people now have healthcare coverage who did not before the ACA. The majority of those with new coverage have obtained it through Medicaid expansion — where are the savings?

Contra Hagedorn’s belief: Studies of Oregon’s Medicaid expansion demonstrate that emergency room visits did not decrease when Medicaid was expanded there. In sum, the senator needs to back up, with hard data, his assertion that access to healthcare is saving the country money.

Hagedorn asserts that the Statewide Healthcare Innovation Plan (SHIP) is working in Idaho. Despite requests, the senator has never produced data that demonstrates SHIP is working. This is simply his opinion.

Hagedorn asserts that the gap population, who would be covered by Medicaid expansion, “are the working poor of Idaho.” However, the senator and others never seem to mention that any adult who works full time already qualifies for subsidized insurance through the state exchange.

Moreover, expansion proponents won’t admit that Medicaid expansion is a disincentive to work full time. Under expansion, with its earning limits, a full-time worker would be encouraged to cap his/her wages in order to qualify for 100-percent taxpayer-funded healthcare.

Unfortunately, Hagedorn isn’t alone in confusing readers on this issue. Malloy attributed this line to Hagedorn: “Many caught in the healthcare gap are children.”

That’s simply not true. And Hagedorn told the Idaho Freedom Foundation he never made that claim.

To correct the record, children of low income families are covered by traditional Medicaid. Medicaid expansion only addresses those over 18 years of age.