View on Medicaid Expansion

With the implementation of the Affordable care Act (Obama care), states have been given the option of expanding Medicaid coverage and the Federal Government will pay the bill.

There are problems under Medicaid – the states pay for the care and submit the bill to the Feds, who in some cases now are refusing to pay, saying the states didn’t follow proper guidelines. Some of those states do not have the money to pay the bill. The guidelines are like a moving target, complicated, constantly changing, and very difficult to comply with.

At the beginning of 2014, Gov. Otter stated that Medicaid expansion was a viable option for Idaho, but this was not the year. I expect he will leave it to the desgression of the legislature this next session.

Implementing Medicaid expansion would relieve the state of financial obligation for the catastrophic fund and the counties for indigent care funds, but keep in mind that it is all paid for with tax dollars, whether federal, state, or county. A big reason to be cautious is the federal govt. could decide to not fund Medicaid at anytime and leave the state in a financial pit.

Expansion of Medicaid may be a good thing for Idaho. Most people in the health care field certainly think so. If we as a state decide to move forward, we should do so very cautiously. The legislature is very divided on this issue and it is uncertain whether it would pass or not. Legislative leadership is reluctant to take on another divisive issue after the controversial State Insurance Exchange.

Arkansas has been the suggested model for Medicaid Expansion for Idaho. Arkansas is now rethinking and rewriting their plan. Instability and uncertainty should cause caution. Further Tort Reform is needed to reduce health care costs. I also feel costs would go down if every receiver of medical care paid something, even for emergency room visits.