Rep. Marv Hagedorn, R-Meridian, asked state Health & Welfare Director Dick Armstrong what the cost will be once 100,000 more people are eligible for Medicaid in Idaho in 2014, under the federal health care reform law. "Because of the way the law was written, the newly eligible individuals, i.e. the single male, it starts out with the federal government paying 100 percent of that cost," Armstrong said. "So we don't have a match that first year." Then, over five years, a state match would phase in, he said.

"Theoretically that expansion wouldn't cost us anything as a state. But that's not what happens, because there's a woodworking effect," Armstrong said. People who are newly eligible tend to come in along with others who already were eligible, like their kids, but who they hadn't previously signed up. "Those are not newly eligible categories, those are historically eligible categories. So our estimate is that there will be about $19 million of cost to the state of Idaho in 2014 because of this rise in eligibility." However, Armstrong noted, "We could say that that $19 million is offset by the fact that the CAT fund is estimated, between 80 and 95 percent of those dollars are for people who now would be eligible for Medicaid. So globally for the state of Idaho, for general funds, we would see a reduction in costs between the various pieces."

People who now turn to Idaho's catastrophic health care fund would become eligible for Medicaid, so the state would no longer have to fund their care through the CAT fund, which is 100 percent state-funded.

Hagedorn asked how much the state would have to pay through Medicaid eventually for the expanded eligibility group. Armstrong said, "It becomes significant. My recollection was that we'll be in the $100 million range, I think, in time," though he noted that that wouldn't be until 2020. "I'll give you the chart," he said. Sen. Dean Cameron, R-Rupert, said, "Several of us may like to see that chart." Armstrong noted, "Remember, it is just a guess," to which Cameron responded, "As is every bit of that whole program."