Idaho’s biggest business lobby backs Medicaid expansion

BOISE - Idaho’s biggest business lobby has come out in favor of Medicaid expansion, which would save the state’s taxpayers hundreds of millions of dollars. It’s a sign that expansion, which could benefit Idaho more than almost any other state given the way it now handles catastrophic medical costs, is slowly gaining traction, despite Idaho lawmakers’ intense dislike for the Affordable Care Act, or Obamacare. The Idaho Association of Commerce and Industry says it’s particularly intrigued by pilot programs in some other states to use the expansion money to just buy private insurance for those patients, and wants Idaho to explore that. “It’s more of a private-sector solution,” said Alex LaBeau, IACI president. “We certainly think it’s worth taking a look at.” IACI took a formal position in favor of expansion at its September board meeting. On Friday, LaBeau sent a letter to Gov. Butch Otter calling 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. Currently, Idaho covers non-disabled adults under its state-federal Medicaid program only if they have children and make less than 20 percent of the poverty level, or $4,584 a year for a family of four. Expansion would cover up to 138 percent of poverty, or $31,000 a year for a family of four; Washington already has opted for expansion. In Idaho, when those patients run up catastrophic medical bills now, local taxpayers have to pick up the tab. A University of Idaho study this year estimated that expansion could save the state budget more than $600 million in the next decade and save county property taxpayers $478 million. Medicaid expansion 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. Caught up in the fight to win approval of a state-based health insurance exchange, Otter last year put off proposing any legislation on Medicaid expansion. But conservative eastern Idaho Rep. Tom Loertscher, R-Iona, chairman of the House State Affairs Committee, proposed two bills himself, saying the move would provide “direct property tax relief.” They never got out of committee, however. When Idahoans who fall into that income category and have no health insurance run up catastrophic medical bills now, 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. Medicaid expansion would provide coverage for roughly 100,000 Idahoans who lack health coverage. Said LaBeau, “Even though we’re not particularly enamored with the federal system, it’s better than the system that we have now. The county indigent program and the state catastrophic program is hopeless, compared to even Medicaid.” He said, “I think it’s worth looking at what some of the other states are doing.”