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Eye On Boise

IACI backs Medicaid expansion, calls for studying insurance-purchase approach

Idaho’s biggest business lobby, the Idaho Association of Commerce and Industry, has come out in favor of Medicaid expansion, a move that could save the state budget more than $600 million in the next decade and save county property taxpayers $478 million. In a letter to Gov. Butch Otter dated Friday, IACI President Alex LaBeau called for re-convening Otter’s task force on Medicaid redesign – which last year recommended the expansion, along with various changes to the Medicaid program – to look at how best to accomplish it.

“IACI supports Medicaid redesign in a manner that is fair to taxpayers, beneficial to employers, adds provider accountability, addresses the inherent inefficiencies in the county indigent program and the state’s catastrophic program, and minimizes the cost shift to business,” LaBeau wrote, reporting the group’s official position, adopted by its board in September; you can read my full story here at

LaBeau is among the speakers at a forum tonight at the Boise Public Library entitled, “Opportunities & Obstacles of Medicaid Expansion;” also speaking are Jim Baugh, executive director of Disability Rights Idaho; Rep. Tom Loertscher, R-Iona, the conservative eastern Idaho lawmaker who last year introduced legislation to expand Medicaid; and Corey Surber, executive director of community health and public policy for the St. Alphonsus Health System. The free forum starts at 7 p.m.

The expansion in question would cover under Medicaid adults who make up to 138 percent of the poverty level, roughly $31,000 a year for a family of four; that originally was a mandatory part of the Affordable Care Act, also known as Obamacare, but the U.S. Supreme Court made it optional for states. Idaho Medicaid now covers non-disabled adults only if they have children and have income of less than 20 percent of the poverty level, or $4,584 for a family of four.

When Idahoans who fall into that uncovered category and have no health insurance run up catastrophic medical bills, whether it’s from accidents or cancer, a county-state program steps in to help with the bills, with county and state taxpayers paying 100 percent of the tab. Liens are placed on everything the patient owns, though little is generally recovered. If Idaho opted to expand Medicaid to cover that same population, the federal government would pay 100 percent of the costs for the first three years, then phase down to 90 percent.

LaBeau said his organization is intrigued by a program that’s been approved as a demonstration project in Arkansas, where the state will take the federal Medicaid expansion funds and use them instead to purchase private insurance for those individuals. “It’s more of a private-sector solution,” he said, adding that Iowa has a similar program awaiting approval. “We certainly think it’s worth taking a look at,” he said.

Last year, Idaho lawmakers declined to take any action on the issue.

Betsy Z. Russell
Betsy Z. Russell joined The Spokesman-Review in 1991. She currently is a reporter in the Boise Bureau covering Idaho state government and politics, and other news from Idaho's state capital.

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