GOP lawmaker touts Medicaid expansion

The Associated Press//March 13, 2013

GOP lawmaker touts Medicaid expansion

The Associated Press//March 13, 2013

A House Republican will introduce a measure March 14 seeking to expand Idaho’s Medicaid program, a key provision in President Barack Obama’s health insurance overhaul.

Rep. Tom Loertscher of Bone said March 12 he’ll introduce two bills: One dissolving Idaho’s existing program to pay indigent people’s medical costs, and a second to expand Medicaid to include people up to 138 percent of the federal poverty line.

Under Obama’s overhaul, the federal government will initially pay for 100 percent of newly eligible Medicaid beneficiaries. But the U.S. Supreme Court forbid Washington, D.C. from forcing this expansion onto states, leaving decisions up to legislators and governors.

Loertscher said he was driven by pragmatism, contending Idaho will save state taxpayer money by expanding coverage under the health care program for the poor, elderly and disabled. Last year, a Seattle-based actuarial firm concluded Idaho will save $6.5 million through 2024 if it expands Medicaid eligibility — and suffer costs of $284 million by rejecting it.

“It’s essential we do it this year,” Loertscher told The Associated Press. “It’s the numbers.”

If lawmakers agree, expansion would include about 104,000 additional people, mostly single adults.

But any decision will almost certainly be hotly disputed; members of Idaho’s GOP-dominated Legislature regularly deride what they call “Obamacare” as socialized medicine.

Idaho senators recently debated another critical provision of the federal law — whether Idaho should adopt a state-based health insurance exchange — for six hours before passing it. The House debated that measure March 13.

So far, Idaho Gov. C.L. “Butch” Otter hasn’t endorsed expansion, despite a recommendation to do so by a 15-member panel he assembled in 2012 to review the consequences for Idaho.

“We have time to do this right, and there is broad agreement that the existing Medicaid program is broken,” Otter said on Jan. 7. “So I’m seeking no expansion of those benefits.”

Otter spokesman Jon Hanian declined to comment on Loertscher’s plans — or whether he’s changed his mind.

He might have some political cover, as some GOP governors have opted for Medicaid expansion, despite their opposition to Obama’s overhaul.

In Florida, Gov. Rick Scott has called for Medicaid for as long as the federal government pays 100 percent of the bill. Arizona Gov. Jan Brewer is backing an expansion of Medicaid, to about 300,000 low-income people. And Maine Gov. Paul LePage is reconsidering his opposition.

Idaho Department of Health and Welfare director Dick Armstrong, an Otter appointee, said his agency is in the process of developing an insurance program to cover newly eligible Medicaid beneficiaries, should Idaho decide to move ahead.

To help address Otter’s concerns about simply continuing Medicaid’s existing policies, Armstrong said Idaho’s program would be modeled closely after a similar push in Indiana that seeks to encourage low-income beneficiaries of the state-federal health insurance program to take more responsibility, including requiring they pay some premiums.

“A piece of it would require a waiver from (the U.S. Department of Health and Human Services) but most of it would just be a modification” to state Medicaid rules, Armstrong told the AP.

The cost of Idaho’s existing system of paying for medical care for its indigent population, called the Catastrophic Fund, has been rising. For 2014, the estimate is about $65 million, $35 million from the state and $30 million from counties.

Under Medicaid expansion, nearly all those costs starting Jan. 1 would be borne by the federal government.

Dan Chadwick, executive director of the Idaho Association of Counties, was at least initially optimistic about Loertscher’s proposal.

“It will end a program that has become a huge burden on the property taxpayers,” Chadwick said. “Quite frankly, the program we have now is an oddity. It’s evolved into an entitlement program, on the state level.”