Bringing the Economy Home

How Rejecting Medicaid Expansion Could Hurt Health Outcomes In Idaho

Emilie Ritter Saunders / StateImpact

Idaho is one of 24 states on track to reject expanded Medicaid coverage for more low-income Idahoans. A recent article by the Los Angeles Times finds states without plans to expand Medicaid have higher rates of colon cancer and breast cancer deaths, and higher rates of gum disease.

The article says the health gap will continue to widen between the states with more Medicaid availability and those without.

Today, for example, about 94% of adults under 65 in Massachusetts have health coverage, the highest rate in the nation. The state guarantees coverage through Medicaid or commercial insurance under a plan developed in 2006 by then-Gov. Mitt Romney, a Republican, and Democratic state lawmakers. By contrast, only 68% of working-age Texans are insured, the lowest rate.

Residents of the two states also have vastly different health outcomes. Potentially preventable deaths, a measure of the overall effectiveness of a healthcare system, are 36% higher in Texas than in Massachusetts, according to data from the Centers for Disease Control and Prevention.

The Times’  piece does acknowledge these health outcomes can’t be solved simply by expanding access to healthcare.

Medicaid by itself may not close those gaps, which also reflect income and education disparities. And the program’s conservative critics, who contend it could ultimately sap state budgets, say poor Americans would be better helped by alternative strategies, including limits on government medical aid to encourage people to take responsibility for their own healthcare.

“Government assistance should not be an entitlement. Government assistance should not be a lifestyle,” said Michigan House Speaker Jase Bolger, a Republican who has called for a complete overhaul of the state’s Medicaid program, including a four-year limit on benefits for nondisabled adults. “Government assistance should be a temporary hand up. It should be a way to improve people’s lives, not trap them in dependency.” – Los Angeles Times

Some members of the Idaho Legislature pushed to introduce Medicaid expansion legislation during the waning days of the 2013 session that ended in March. The bills didn’t go anywhere.

Republican Gov. C.L. “Butch” Otter says he hasn’t decided whether he’ll support Medicaid expansion in Idaho. Instead, Otter said last month a panel will continue to study the state’s options and pick up the debate when the 2014 Legislature convenes.

It’s likely Idaho will forgo at least some the financial benefit of Medicaid expansion since implementation begins during the fiscal year that starts in July. As StateImpact Idaho has previously reported, the state would give up as much as $16.6 million if Medicaid expansion is delayed by six months until the start of the 2015 fiscal year (July 1, 2014).


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