Recently, Idaho Rep. Ilana Rubel presented a list of state rankings that placed Idaho near the bottom on several metrics, like per capita income. She concluded by calling for more government investment (read: spending) in education and healthcare. Specifically, Rep. Rubel called for expanding Idaho’s $2.45 billion Medicaid program.

Rubel argued, “By refusing to expand Medicaid, Idaho is giving up a fortune to other states, using local tax dollars to overpay for healthcare at home…” Sorry, Rep. Rubel, but that is not correct. Medicaid expansion wouldn’t reduce Idaho’s health care spending, but would simply increase Medicaid expenditures from the federal government (and from Idaho’s General Fund).

Furthermore, a federal “fortune” is not given to other states if Idaho doesn’t expand Medicaid: it simply never gets appropriated. That’s because the federal money for expansion doesn’t yet exist. Medicaid expansion would not be funded by diverting a stream of federal tax dollars to Idaho, but by adding to the already existing $21 trillion federal debt. Thus, expansion has no effect on other states, besides making Idaho more attractive to able-bodied adults seeking “free” health care. Expanding Medicaid would only add to already unsustainable federal borrowing.

Note: This was first published as a letter to the editor in the Idaho Statesman. Click here to see that post. 

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