Despite Gov. Butch Otter saying during his State of the State message that he does not intend to pursue an expansion of the federal Medicaid welfare program this year, a member of the Idaho House has nonetheless crafted legislation to make it happen.
“I have a bill and I have spoken with the chairman about it,” House Minority Leader John Rusche, D-Lewiston, told IdahoReporter.com, referring to Rep. Fred Wood R-Burley, chairman of the House Health and Welfare Committee.
A member of the Senate Health and Welfare Committee, however, says that he not only opposes Medicaid expansion, he also doesn’t expect such a proposal. “No, I don’t see that happening,” said Sen. Marv Hagedorn, R-Meridian, when asked if anticipated a proposal like Rusche’s coming to his committee.
“We know that there is a portion of the population that is uninsured and that is to be taken seriously,” Hagedorn said. “But every time somebody comes to me and says that expanding Medicaid is a good idea, I ask them ‘do you go into debt every month to buy health insurance?’ and the answer I get is ‘no.’ Then I ask them ‘why would you want our state to go into debt that way?’ People act as though federal funds we would receive from Washington for Medicaid expansion is like free money, but it is not.”
Hagedorn explained that “roughly 40 cents of every federal dollar is debt. I don’t care what you call it, Medicaid expansion, Medicaid re-design, whatever, it is debt. We need to take care of people who are uninsured, but Idahoans are going to need to have skin in the game to do this, and I’m not sure we’re there yet.”
Begun in 1965, the Medicaid program provides certain health care services to individuals and families with low incomes and limited resources. Financed with a combination of federal and state tax revenues, the expanding costs of Medicaid have in recent years become a topic of growing concern among the individual states, despite the eligibility of the program being based on a variety of means testing processes.
A key component of President Barack Obama’s Affordable Care Act law was to have mandated that the individual states reduce eligibility requirements for Medicaid and expand the number of participants in their respective programs. However, the United States Supreme Court overturned that component of the Obamacare law, so expansion of Medicaid is an elective choice for each of the states.
In 2013 Otter announced that he believed Idaho’s Medicaid system was “broken,” and he was therefore not seeking to expand it. He did, however, appoint a task force last year to investigate the possibility of Medicaid expansion. The task force unanimously recommended that Otter move forward on an expansion plan. Rep. Fred Wood was a member of that task force.
Later in 2013 Rep. Pete Nielsen, R-Mountain Home, noted that Medicaid provides a person with “retroactive coverage” for medical procedures, a benefit that private insurance does not provide. Nielsen also raised concerns at that time that some health care providers may come to prefer Medicaid patients over those with private insurance, simply because their likelihood of reimbursement could presumably be better with the federal welfare program than they would be with a private insurance policy.