{"id":14533,"date":"2013-01-09T11:02:46","date_gmt":"2013-01-09T18:02:46","guid":{"rendered":"http:\/\/stateimpact.npr.org\/idaho\/?p=14533"},"modified":"2013-01-09T11:02:46","modified_gmt":"2013-01-09T18:02:46","slug":"what-gov-otter-meant-when-he-said-no-to-expanding-medicaid-eligibility","status":"publish","type":"post","link":"https:\/\/stateimpact.npr.org\/idaho\/2013\/01\/09\/what-gov-otter-meant-when-he-said-no-to-expanding-medicaid-eligibility\/","title":{"rendered":"What Gov. Otter Meant When He Said “No” To Expanding Medicaid Eligibility"},"content":{"rendered":"
\"\"<\/a>

Emilie Ritter Saunders \/ StateImpact<\/p>

Dr. Ted Epperly is the Program Director of the Family Medicine Residency of Idaho.<\/p><\/div>\n

Gov. C.L. “Butch” Otter said in Monday’s State of the State address<\/a> that he doesn’t believe Idaho should expand Medicaid eligibility<\/a>.\u00a0 “There is broad agreement that the existing Medicaid program is broken,” he said.<\/p>\n

That wasn’t all the governor had to say on the issue.\u00a0 He mentioned a new responsibility for Idaho Department of Health and Welfare Director Richard Armstrong.\u00a0 “I’m asking Director Armstrong to lead an effort to flesh out a plan for changing Idaho’s system with an eye toward the potential costs, savings and economic impact,” he said.\u00a0 “I hope to return in 2014 with specific proposals based on that work.”<\/p>\n

That left a few people, this reporter included, scratching their heads.\u00a0 What does that mean, exactly?\u00a0 <\/p>\n

The panel Gov. Otter created to study a possible expansion of Medicaid unanimously supported expanding eligibility<\/a>, but it also issued two conditions<\/a>.\u00a0 The group’s final report<\/a> to the governor says the Medicaid plan should have “built-in accountability requirements.”\u00a0 It also recommends Idaho’s health care delivery system be redesigned to create incentives for quality<\/em> rather than frequent<\/em> care.<\/p>\n

Director Armstrong says it’s now his charge to develop a plan that follows through on those recommendations.<\/p>\n

“The way I’m going to pursue it is to build out a proposal that really does detail the inner workings of the various components of the recommendation,” he says.\u00a0 That proposal will lay out how the state will move away from fee-for-service health care to value-based health care, and also create a benefit plan that holds those enrolled in the program more accountable, he says.\u00a0 Ideas that have been floated include establishing a low monthly premium for coverage, for example.<\/p>\n

But the state does not have the luxury of designing its own program however it sees fit.<\/p>\n

Under the Affordable Care Act, the federal government initially would cover 100 percent of the costs of Medicaid expansion, phased down to 90 percent by 2020.\u00a0 Moreover, according to an analysis by consulting group Milliman<\/a>, the Medicaid expansion would save the state and counties\u00a0 $6 million over the next 10 years.\u00a0 The state could not afford to expand Medicaid eligibility without federal funds.\u00a0 Consequently, Armstrong says, the state is asking the federal Centers for Medicare & Medicaid Services (CMS) for guidance.\u00a0 “Whatever we do has to be with the approval of CMS,” Armstrong says.<\/p>\n

Dr. Ted Epperly, director of the Family Medicine Residency of Idaho, says he’s disappointed by the governor’s decision that the <\/strong>Legislature should take no action on the Medicaid expansion this year.\u00a0 Epperly was a member of Gov. Otter’s workgroup, and cast one of the 15 votes in favor of expanding Medicaid eligibility for low-income adults.<\/p>\n

“I do believe Gov. Otter has something in mind,” he says.\u00a0 “The problem I see with this is that the clock is ticking.”\u00a0 He points out the federal government will pick up the full cost of expanding Medicaid eligibility for a limited time.<\/p>\n

“Every day we wait, we lose federal funding to expand health care to many Idahoans,” he says.<\/p>\n","protected":false},"excerpt":{"rendered":"

Gov. C.L. “Butch” Otter said in Monday’s State of the State address that he doesn’t believe Idaho should expand Medicaid eligibility.\u00a0 “There is broad agreement that the existing Medicaid program is broken,” he said. That wasn’t all the governor had to say on the issue.\u00a0 He mentioned a new responsibility for Idaho Department of Health […]<\/p>\n","protected":false},"author":46,"featured_media":11475,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[15],"tags":[210,27,65],"acf":[],"_links":{"self":[{"href":"https:\/\/stateimpact.npr.org\/idaho\/wp-json\/wp\/v2\/posts\/14533"}],"collection":[{"href":"https:\/\/stateimpact.npr.org\/idaho\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/stateimpact.npr.org\/idaho\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/stateimpact.npr.org\/idaho\/wp-json\/wp\/v2\/users\/46"}],"replies":[{"embeddable":true,"href":"https:\/\/stateimpact.npr.org\/idaho\/wp-json\/wp\/v2\/comments?post=14533"}],"version-history":[{"count":0,"href":"https:\/\/stateimpact.npr.org\/idaho\/wp-json\/wp\/v2\/posts\/14533\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/stateimpact.npr.org\/idaho\/wp-json\/wp\/v2\/media\/11475"}],"wp:attachment":[{"href":"https:\/\/stateimpact.npr.org\/idaho\/wp-json\/wp\/v2\/media?parent=14533"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/stateimpact.npr.org\/idaho\/wp-json\/wp\/v2\/categories?post=14533"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/stateimpact.npr.org\/idaho\/wp-json\/wp\/v2\/tags?post=14533"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}