To Expand Or Not To Expand? Governor’s Work Group On Medicaid Meets Monday

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It's not yet clear whether Idaho will elect to expand Medicaid eligibility and accept federal funding provided under the health care law.

A big question facing Governor C.L. “Butch” Otter after the Supreme Court ruled last month on the health care law is this: should Idaho expand its Medicaid program?

If states opt in and expand Medicaid eligibility to 138 percent of the poverty line, the federal government will pick up much of the tab, covering 100 percent of states’ expansion costs for the first two years, phased down to 90 percent by 2020.

Otter has appointed a panel of 15 lawmakers, industry and government experts to study Idaho’s options.  That panel will meet for the first time Monday.

As StateImpact reported last month, there’s a case to be made that expanding Medicaid might actually save the state money.

Here’s a list of questions from the Department of Health and Welfare the Medicaid panel will address:

• What are the demographics and the number of individuals who would be included in an expansion population?

• What are the health care needs of the Medicaid expansion population?

• What is the financial impact to Idaho’s healthcare providers with and without expansion?

• Does expanding Medicaid eligibility improve access to appropriate and necessary health care?

• What health care delivery capacity must exist to provide access to an expanded Medicaid population?

• What current programs would be eliminated or reduced if Idaho expands Medicaid eligibility? What would the impact be on the Catastrophic Health Care system?

• With the federal funding formula changes beginning in 2014 at 100 percent and decreasing to 90 percent by 2020, what plans would need to be in place to assume responsibility for State matching funds?

• Is there a way to estimate the future funding needs for the State’s 10 percent?

• To what poverty level, if any change, should Idaho expand its Medicaid eligibility? Are there advantages/disadvantages to setting the poverty level maximum lower than 138 percent?

• What State strategies should be pursued, if any to avoid and/or minimize “crowd out effects” when individuals with commercial insurance drop coverage to obtain Medicaid

• What are the administrative costs of expanding Medicaid eligibility?

• How and by whom should coverage be administered if Medicaid eligibility is expanded?

• What Department of Health and Welfare administrative costs may decline or be eliminated if Medicaid eligibility is expanded?

• What types of outreach strategies should be pursued to enroll individuals if Medicaid eligibility is expanded?

• Is expanding Medicaid in the financial best interests of Idaho

• If Medicaid eligibility is not expanded is there an option for Idaho to create a program to extend health care services to people who are not eligible for Medicaid or the federal subsidies? How would an alternative option affect the Catastrophic Health Care system

Monday’s meeting starts at 10:00 a.m. at the Pete T. Cenarrusa Building, 450 West State St., in Boise.  We originally reported an audio web-stream of the meeting would be available, but that has been canceled.