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Messy Idaho Medicaid expansion will stay - for now

Updated: Jul 21, 2023

It's been five years now since Idaho voters approved a ballot measure adopting Medicaid expansion. As we've previously written, the promises of the expansion went out the window a long time ago.

The latest numbers show enrollment is more than double the projection - more than 1 in 4 Idahoans are now enrolled.

There were also at least 83,000 ineligible enrollees reported in January 2021. These enrollees do not meet traditional eligibility standards, but state officials are unable to remove them from the program because of the congressional handcuffs.

There were state-sought waivers to make changes to the program for the betterment of Idaho. Four were requested, and only one has been approved.

All of this - plus the enormous cost - have given many lawmakers and policy watchers heartburn.

In the last legislative session, legislators increased the state’s Medicaid budget. And it’s also now the state’s largest agency budget.

The House Health and Welfare Committee has made a recommendation that Medicaid expansion stay in place, at least for now. The committee said it had "serious concerns" about the program at the present time, including the “unsustainability of the current increased budget request.”

The committee also sent these six recommendations to the Speaker of the House.

So what should have been done? We laid out some ideas here, courtesy of the Foundation for Government Accountability. One of the recommendations was to remove previously ineligible enrollees. It appears at least that part is being addressed and the timeline to do it is being moved up. And re-evaluating the program again in 2025 is also a good thing.

In addition to concerns about the cost of the program, Medicaid coverage can be extremely limiting. Not only do providers run into billing problems, but reimbursement rates are also extremely low. Many health care providers will only take a limited number of patients. So, while citizens may have coverage, it might not mean much.

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