Idaho, expand Medicaid program

If you had an opportunity to vote for a piece of legislation that could improve the state's economy by creating 16,000 new jobs, save state and county governments approximately $290 million, promote personal responsibility and lower health care costs for approximately 150,000 of Idaho's citizens, how would you vote?

Our legislators are considering the expansion of Idaho's Medicaid program. This is likely to be a difficult and contentious issue, but here are purely economic reasons why Gov. Otter's Health Care Task Force voted 15-0 in favor of the proposed expansion:

1. It saves Idaho money: The expansion of Medicaid to 150,000 Idahoans will cost Idaho $284 million over the next 10 years. However, the federal government's payments for the expansion will bring in $290 million over that time. Idaho nets a gain of $6 million by expanding Medicaid. Without the expansion, health care coverage for 70,000 Idahoans who already meet the expanded eligibility requirements will cost Idaho taxpayers hundreds of millions of additional dollars without the benefit of enhanced federal reimbursement.

2. Job creation: The economic impact on Idaho is impressive as the health care dollars introduced into the economy have the potential to create 16,000 new jobs and increase both personal income and state and local tax revenues. Economists estimate Idaho will gain approximately $616 million in sales, property and income taxes by expanding Medicaid.

3. It stops cost shifting: If Idaho chooses not to expand Medicaid, 80,000 Idahoans could potentially remain uninsured. When the uninsured get sick and can't pay their medical bills, they often end up in the emergency room. If the bill is not paid, the health care of every other hospital user is increased to cover the loss. Increased medical costs also impact private insurance companies, who will need to increase premiums for the insured. Each of us currently pays a portion of the cost for the uninsured in our insurance premiums and our health care costs. That will continue if Medicaid is not expanded or we keep the status-quo.

4. Idaho will pay for Medicaid expansion by other states: If Idaho doesn't expand Medicaid, we will still pay for the expansion with our federal taxes. Those additional tax dollars paid by Idaho taxpayers will flow out of Idaho to other states that have expanded Medicaid to their citizens. Even Jan Brewer, the conservative governor of Arizona, has announced that Arizona will expand its Medicaid program. Idaho taxpayers will help pay the cost of Medicaid expansion in other states.

5. Personal responsibility: The Governor's Task Force said the expansion of this program will help Idahoans become more responsible and accountable for their health care. By aligning incentives that promote positive health behavior we can lower health care costs, address chronic issues such as diabetes and obesity, and help promote healthier communities. You may not think about another person's health issues until that person is standing behind you with the flu in the check-out line at the grocery store.

6. Reduced state and county costs: Currently, counties and the state medical indigent funds pay for qualifying uninsured people who default on medical bills that exceed $10,000. Medicaid expansion will reduce state and county indigent health care expenses by 90 percent and save counties and the state $290 million over 10 years. This results in lower state and county taxes.

7. Produce healthier Idahoans: Studies have demonstrated that the key to improving health care outcomes is timely access to health care. Consistent access to care (wellness, prevention, mental health and chronic disease management) decreases higher cost downstream, including ER utilization and hospitalization. It is much more expensive to take care of sick people than it is to keep people healthy.

The economic issues considered by the Governor's Health Care Task Force are compelling. No matter how you feel about Obamacare, the program has been approved by Congress and confirmed by the Supreme Court. In light of that, the expansion of the Medicaid program in Idaho appears to be a fiscally conservative and economically sound decision.

Len Crosby is a board member of Dirne Community Health Center.