The state's biggest issue of 2015

Idaho legislators will be put to a great test in the session that opens this week. Will they have the fortitude to vigorously debate a proposal to close the Medicaid gap?

There's strong speculation that this fiscally prudent, politically charged matter won't ever see the light of serious reflection. That's because the Medicaid issue is related to Obamacare - and as we're all repeatedly told, Idahoans don't support Obamacare. We contend that objection to one should not preclude serious consideration of the other.

You probably already know that expanding Medicaid would assist nearly 80,000 Idahoans who don't qualify for a health insurance subsidy. Roughly two-thirds of these people are working, but poor. Without health insurance, they tend to wait until they're extremely sick, then exercise the least efficient and most costly option for medical help: the emergency room. That places a financial burden on hospitals that write off many of the excessive costs, but pass along to taxpayers the rest in the name of indigent care.

We have the ability to change that destructive, expensive dynamic. The federal government - to some, another bogeyman in the closet - has offered to pay all the additional Medicaid freight initially, scaling back to 90 percent of the additional cost over time. Even paying 10 percent eventually, Idaho would be moving ahead financially, and not just because Uncle Sam would be returning some of your hard-earned tax dollars through this program.

According to a report compiled by a work group appointed by Gov. Butch Otter in 2012, Medicaid expansion would bring an estimated $9.24 billion in federal funds into Idaho over a 10-year period. On top of that, a study by the Idaho Hospital Association predicts Medicaid expansion would create about 16,000 new jobs in Idaho that would generate an additional $615 million in sales, income and property taxes over that 10-year period.

We're calling on North Idahoans to help legislators get past "feeling dirty" about accepting federal help in closing our Medicaid gap. Citizens should assure elected officials that despite mutual distaste for Obamacare, their greater passion is for the state's fiscal strength in addressing needs that go beyond health care's moral imperatives.

Thousands of new jobs and hundreds of millions of dollars into the state's coffers at no additional cost to Idaho taxpayers? That's way too much upside for lawmakers to keep ignoring because they don't like Obama or Congress.