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Otter still won’t endorse Medicaid expansion even as cabinet member crafts legislation

Otter still won’t endorse Medicaid expansion even as cabinet member crafts legislation

Dustin Hurst
April 29, 2015
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April 29, 2015

Idaho Gov. Butch Otter still won't endorse Medicaid expansion, even after a news report revealed one of his top lieutenants worked for that cause in 2015.

Otter, after answering questions about a child support bill in his ceremonial office Wednesday, told IdahoReporter.com his administration remains in an advisory role on expansion.

The governor, who has never been able to close the door on Medicaid expansion, said that following the 2012 U.S. Supreme Court ruling that allowed states to choose to expand, he promised the legislative branch to provide information, technical expertise and guidance.

“I’m holding true to that guarantee and that promise,” Otter told the room full of reporters. “We are honor-bound by the pledge to provide that kind of information.”

Armstrong, at the governor’s side Wednesday, didn’t speak to the issue.

The governor, in his third term, has had several opportunities to end the speculation and close the door on swelling the government health care program. In a gubernatorial debate last year, for example, Otter said Idaho “probably” wouldn’t expand Medicaid. At the beginning of the year, too, he asked lawmakers to examine the idea, but stopped far short of an endorsement either way.

A new report from the Boise Weekly sheds some light on the activities of Dick Armstrong, head of the Idaho Department of Health and Welfare. During the 2015 session, Armstrong, a member of Otter’s cabinet, pitched expansion to legislators in information hearings only.

At least that’s what the public saw.

The Boise Weekly’s George Prentice offered this take Wednesday:

In yet another twist, BW has confirmed that Richard Armstrong, director of the Idaho Department of Health and Welfare, helped to craft a second Medicaid redesign proposal in mid-March and delivered the measure to LSO. That piece of legislation didn't see the light of day either, leaving proponents of Medicaid redesign in the lurch until 2016 at the earliest.


Otter’s work on the Medicaid issue, which foot soldiers and other interested parties dub “Medicaid Redesign,” has apparently thrilled some.

"To the great credit of the governor, he was not one of those Republican governors who said, 'Hell no, we won't go.' He wanted to look at Medicaid more closely," Corey Surber, executive director of Community Health and Public Policy for Saint Alphonsus Health System, told Boise Weekly.

The draw toward Medicaid expansion is significant. Idaho could offload serious healthcare costs, maybe as much as $173 million a year, on to the federal government, which would likely free up cash in state and county budgets for spending on other items.

Swelling government health care would add around 80,000 Idahoans to the program, mostly childless adults who work.

Expansion, though, comes with unintended consequences.  The Associated Press revealed just days ago Medicaid expansion has enticed more and more Americans to participate in the country’s food stamp program.

“With the economy improving, national food-stamp enrollment declined in 2013 and 2014,” the AP report revealed. “But in 11 states, demand rose between January 2013 and the end of 2014, the AP analysis showed.”

“Ten of those states expanded their Medicaid programs under the health law. Florida did not expand Medicaid but led the nation in health law enrollment in private insurance plans.”

Idaho’s food stamp usage has dropped from 13.71 percent of residents participating in January 2014 to 12.53 receiving benefits as of this March, Idaho Department of Health and Welfare data reveal.

House Minority Leader John Rusche, D-Lewiston, and Sen. Dan Schmidt, D-Moscow, rallied to push Idaho Republicans to expand government health care in the 2015 session’s final days, but the cry fell on deaf ears. Rusche and Schmidt are both retired doctors.

Another lawmaker-doctor, Rep. Fred Wood, R-Burley, served as a lone voice in the GOP caucus to endorse Medicaid expansion this year.

Advocates say they will continue the fight for more government health care when lawmakers begin their work again in Boise next January.

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