The expansion, a component of the five-year-old federal Affordable Care Act, would deliver billions of dollars in federal assistance to Idaho over the next 10 years and save the state $173 million during the same period in expenses for state and county indigent-care program.
But state Republicans, stung by criticism for approving a state healthcare exchange under the ACA in 2013, oppose any further implementation of ACA-related provisions. The Republican House Speaker, Scott Bedke, said Thursday there was not support within the caucus for expansion.
Idaho stands to receive a waiver from the federal government on how it would implement expansion here, addressing concerns over local control. As proposed, the state could use federal funds to create a hybrid program of managed care for that gap group and give another 25,000 low-income people access to subsidized private insurance via the state exchange.
Besides saving Idaho taxpayers millions of dollars, expanding Medicaid would improve healthcare for about 78,000 poor Idahoans currently do not qualify for Medicaid or for subsidized private insurance. It would also save hundreds of lives yearly.
“The financial case (for expansion) is undeniable,” said. Rep. John Rusche, D-Lewiston, the House minority leader. “What really gets me is the fact that uninsured people have shorter lives, they have work history that is interrupted by illness, and an increase in death.”
Gov. Butch Otter, in his 2015 State of the State address in January, asked the Legislature to review the findings a workgroup he impaneled that recommended expansion. The House and Senate Health and Welfare committees held hearings but no legislation came forward.
Rusche and Sen. Dan Schmidt, D-Moscow, said committee chairmen in both houses said they would not take up any bills without support for them from leadership. They acknowledged
“I’m looking at going home, and it’s time to talk about this before going home,” Schmidt said. “Look at the Senate calendar. It’s almost empty.”
House Speaker Scott Bedke, R-Oakley, acknowledged still-strong opposition to Medicaid expansion within his caucus.
I don’t think anything has changed here at the eleventh hour of the session,” he said. “They just don’t want to do it.”