Medicaid gets Idaho Association of Commerce and Industry support

BOISE – Idaho’s biggest business lobby has come out in favor of expanding Medicaid for Idaho’s poor, a move expected to save state taxpayers hundreds of millions of dollars.

It’s a sign that Medicaid expansion is gaining traction despite Idaho lawmakers’ intense dislike of the Affordable Care Act, or Obamacare. Broader coverage for the poor could help Idaho more than most other states because of the way it handles catastrophic medical costs.

The Idaho Association of Commerce and Industry is intrigued by pilot programs in other states that use the federal expansion money to buy private insurance for Medicaid patients.

“It’s more of a private-sector solution,” said Alex LaBeau, IACI president. “We certainly think it’s worth taking a look at.”

The association took its position in favor of Medicaid expansion at its September board meeting. LaBeau sent a letter Friday to Gov. Butch Otter calling for reconvening a task force on Medicaid redesign – which last year recommended the expansion, along with changes to the Medicaid program.

“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.

Idaho covers adults who aren’t disabled under the Medicaid program if they have children and make less than 20 percent of the poverty level, or $4,584 a year for a family of four. When those patients run up catastrophic medical bills, local taxpayers have to pick up the tab. Liens are placed on everything the patient owns, though little is generally recovered.

Expansion of the Medicaid program would cover those with incomes of up to 138 percent of the poverty level, or $31,000 a year for a family of four. Washington already has opted for expansion.

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 had been a mandatory part of the Affordable Care Act until 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.

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.” The bills died in committee.

If Idaho opted to expand Medicaid, 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 100,000 Idahoans who lack health coverage.

“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,” LaBeau said. “I think it’s worth looking at what some of the other states are doing.”