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Medicaid expansion: A real success story for Idaho

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David Nelson

Idaho’s politicians have all kinds of snappy quotes about health insurance. How it doesn’t keep you healthy, and how no one’s every died from not having it — but that’s simply not true. Research shows those with health insurance are healthier than those without because they can access regular doctor’s visits and preventative care. Helping everyone access health insurance should always be a legislative priority, and it’s never been more urgent than it is now amid the COVID-19 pandemic.

Luckily, in 2018, Idaho’s voters passed Medicaid expansion, which was expected to bring Medicaid coverage to about 90,000 Idahoans, and as of Jan. 5, 2021, about 100,529 Idahoans had signed up for expanded coverage. The overall number of Medicaid recipients has grown, partly because of people losing their jobs during the initial economic contraction in the early days of the pandemic.

With more people needing coverage and many of them with untreated health conditions, it has meant our cost estimates were low, unfortunately. But with a higher federal government contribution during the pandemic for traditional Medicaid, we’re actually saving state dollars in the short term. For example, the Idaho Department of Correction saved $8.3 million over the last two fiscal years because of Medicaid expansion, which picked up a portion of what had previously been fully state-funded costs. Investing in this necessary health care service also makes fiscal sense for our state, not just our citizens. We will have to deal with the growing pains after the pandemic, but frankly, I’m willing to pay a little bit more to ensure people have the insurance coverage they need so they can better contribute to the Idaho economy.

And Medicaid expansion has been a lifeline to our rural critical-access hospitals. Even now, according to the Idaho Hospital association, 20 out of 27 are running at a net operating margin during the pandemic. Without it we probably would have seen several of them close in the last two years.

We want everyone to be able to get tested and vaccinated, and, should they need it, get the emergency care they need if they contract the coronavirus. People shouldn’t have to fear for both their financial and physical health. Plus, as case numbers lessen and our economy recovers more fully, the number of people seeking Medicaid expansion should naturally start to decline.

Instead of grumbling, legislators in Idaho should be glad Idahoans are receiving the care they need, and fund Medicaid like voters asked us to. Medicaid expansion passed with 61% of the vote overall as well as the majority of the vote in almost every county. Our constituents are benefitting from this, including over 2,200 of my constituents in District 5, and are receiving health coverage through expanded Medicaid. I’m happy to see the program doing its job, and I hope we see this program flourish and be fully funded for many years to come.

David Nelson is a state senator and Democrat representing Moscow.

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