Idaho’s Medicaid Expansion Workgroup Explores Three Options

Emilie Ritter Saunders / StateImpact

The governor's panel on Medicaid expansion met for the first time back in August.

Between 97,000 and 111,000 additional Idahoans would be eligible for Medicaid if the state chooses to expand eligibility.  But where would those people come from?  Close to half would migrate from four other state programs already in place to help low-income residents with medical needs.

Governor C.L. “Butch” Otter must decide if Idaho will expand its Medicaid program under the federal Affordable Care Act.  A workgroup he assembled has been weighing the state’s options, and met for a second time Thursday in Boise.

If the state expands eligibility, about 35,000 people would migrate to Medicaid from community health centers.  Another 6,000 would come from Idaho’s Catastrophic Health Program.

Laura Summers is with Leavitt Partners which conducted a $100,000 study for the Idaho Department of Health and Welfare on Medicaid expansion.

“Idaho’s population, newly eligible population, is going to consist of a both a younger, relatively healthy population,” Summers explains.  “A lot of those mothers who are receiving treatment at community health centers with less serious chronic [conditions] as well as an older population with more serious chronic conditions.”

Another 4,300 would come from Idaho’s Adult Mental Health Services.  And 2,000 would switch over from the Corrections Department as they are released from prison.

The rest of the newly-eligible would come from other programs or among the ranks of the uninsured.  The Leavitt report says 64 percent of those newly-eligible for Medicaid would have jobs, but would not have health insurance.

The workgroup also explored what it considers to be Idaho’s three options surrounding Medicaid and the federal health care law.  The first is to do nothing — no expansion.  The second is to not expand Medicaid, but to overhaul Idaho’s existing medical indigency program, known as the Catastrophic Health Care Fund (or CAT fund).

Dan Chadwick is the head of the Idaho Association of Counties.  He says the CAT system is too complicated to re-design. He’d rather scrap the whole thing and start over.

“Many of the providers and the counties really don’t like this system,” Chadwick said.  “I think we’d all be happy to see it go away, it’s created conflict over the years, it’s a difficult system to administer, and we don’t know even where to start in terms of capturing the administrative costs for this.”

The third option the workgroup sees is to recommend an expansion of the Medicaid program.

The costs of each option are still being worked out by the Seattle-based consulting firm Milliman.  That firm plans to give its report to the working group at its next meeting scheduled for October 23.  Once those numbers come out, the working group will pick an option and recommend it to Gov. Otter, who must make a final decision by mid-November.