It’s Unanimous: Idaho Should Expand Medicaid Eligibility

Emilie Ritter Saunders / StateImpact Idaho

The group considering the Medicaid expansion met at the Capitol today

All fourteen members of Gov. C.L. “Butch” Otter’s Medicaid Expansion Work Group arrived at the same opinion this afternoon: Medicaid eligibility should be expanded in Idaho.  It was the conclusion of a months-long discussion and research set in motion when the U.S. Supreme Court ruled in favor of the Affordable Care Act earlier this year.

Expanding Medicaid eligibility to low-income adults living at or below 138 percent of the federal poverty line is a key component of the federal health care law.  But the Supreme Court’s June ruling in effect granted states the right to choose whether to adopt the expansion.

This morning, Gov. Otter’s working group heard a presentation from consulting group Milliman, which was hired by the state to assess the costs and savings of the state’s options. The report estimates expanding Idaho’s Medicaid program would save the state money between now and the year 2024.  That’s because the federal government will at first cover 100 percent of the cost of expansion, phased down to 90 percent by 2020. 

That should lower the state’s catastrophic health care and indigent care spending, Milliman concluded, because many Idahoans currently covered by those programs would become Medicaid-eligible.  It was one factor that working group members cited in arriving at their decision this afternoon.

The Idaho Hospital Association’s Steve Millard said he was concerned that the federal-state funding split could shift over time and become less favorable to states.  But he said that all of the information he had heard was “very compelling” that the state should pursue the expansion.

“I think, quite frankly, option three is the only option that makes practical and pragmatic sense,” said Dan Chadwick, executive director of the Idaho Association of Counties.  Option three is the expansion of Medicaid eligibility to 138 percent of the federal poverty level.

The group also stressed that if Medicaid eligibility is to be expanded, that should happen with an eye toward cost containment.

“We can see through the information that’s been give us over the last several months that this would be good for our people in Idaho,” began Sen. Patti Anne Lodge (R-Huston).  “But we must have some guidelines for people who are on programs.”

The members plan to include caveats in their recommendation that stress personal responsibility and accountability, among other things.  The final document should go the governor next week.