Monday, April 22, 2024

OPINION: For the sake of those who need it, we need to save Medicaid

by REP. JORDAN REDMAN/Guest Opinion
| January 31, 2024 1:00 AM

Idahoans are generous people. We work hard and we look out for each other. 

I’ve lived in North Idaho my entire life and the strength of our communities is what makes our state an exceptional place to call home. We all want to help our neighbors who truly need it — that’s who we are. 

But the hard truth is that we have real financial limitations. 

Welfare spending in Idaho is out of control. Medicaid expenditures in 2023 will be more than the state's total budget just 10 years ago. Think about that. Every dollar we spent to keep our state open a decade ago is now what it costs to run Medicaid alone. 

Some might be wondering how this happened. 

Medicaid was created as a safety net for the truly needy. But forces in Washington, D.C., have warped it into a spending vehicle that is driving state budgets off a cliff, and Idaho is next. 

When Idaho expanded Medicaid to the able-bodied under ObamaCare, we were promised that only 62,000 able-bodied adults would enroll. In reality, as more Idahoans moved from private insurance to Medicaid and the federal government tied our hands, it was double that number. 

With more than 120,000 able-bodied expansion enrollees, Medicaid has caused truly astounding budget pressures and workforce impacts. Our labor force participation rate has dropped by an alarming nine percent statewide since 2000.

If we want to help those with a true need for Medicaid, we cannot allow ourselves to stretch the program until it snaps. 

A great place to start “Mending Medicaid” is with a new piece of legislation I’ve introduced that takes moderate steps to shift power over the program from Washington, D.C., to Boise and rid the program of obvious abuse and fraud.

It will close loopholes that lead to improper and fraudulent payments, make us more diligent about cross-checks and eligibility verification, implement commonsense guardrails for enrollment, and ensure that able-bodied Idahoans on Medicaid that can work, do work. 

Right now, the able-bodied adults in our expanded Medicaid program are not required to work, train or volunteer — even part time — as a condition of enrollment. There is also no limit on the amount of time they can collect benefits. 

The Idahoans I talk to who supported Medicaid expansion did not have this in mind. They wanted to help individuals who hit a rough patch and can’t provide for themselves — not long-term or lifelong government dependency.  

Instead, the status quo hurts everyone. It takes scarce resources away from the truly needy while holding people back from improving their quality of life. 

When able-bodied people leave welfare, their incomes increase. Studies in multiple states have concluded that food stamp work requirements triple the incomes of those leaving the program within two years, on average. When Arkansas temporarily implemented work requirements for Medicaid, about 14,000 people left the program for more lucrative opportunities. 

Right now, people can enroll in our Medicaid program without even proving they live in Idaho. I wish I were kidding. The agency accepts “self-attestation” when it comes to claims of residency, household composition and caretaker status — we simply take people’s word for it. 

Depending on who you ask, somewhere between one and two of every five dollars spent on our Medicaid program is spent improperly. Imagine the families we could be helping with that money. Or what you could have done with the extra take-home cash, had it never been taxed away from you in the first place. 

Safeguarding against loopholes and fraud, cross-checking, and verifying eligibility are simple reforms that allow us to keep helping those who truly need it. These reforms can even allow us to continue providing Medicaid benefits to able-bodied adults. 

This legislation asks for the federal government to give Idaho the flexibility to ensure our state dollars are being used wisely and on the families who need them the most. 

You have to be strong yourself before you can help others. It’s true for people, and it’s true for safety net programs. Our Medicaid program is on an unsustainable path, and for those whose lives depend on this program, we have a moral responsibility to fix it.

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Jordan Redman is serving his first term representing District 3 in the Idaho House of Representatives.