Medicaid expansion is crucial for a healthy Idaho

Lawmakers should arrive in Boise next month prepared to defend the will of the people who put them into office, writes guest columnist Randy Johnson. (Getty Images)

When voters initiated and overwhelmingly approved expanded Medicaid coverage for 88,000 of our family, friends and neighbors who did not previously qualify, it was a significant statement that Idahoans care for our own. 

The 2018 ballot initiative was – and is – a massive victory for the entire state, but especially for anybody who now has access to health care when they previously went without. Regular health care visits and access to preventative screenings lead to earlier discovery and better treatment options for cancer and other life-threatening diseases and chronic conditions. Catching these conditions early saves lives.

Those newly insured folks previously fell into the coverage gap, with incomes above the state’s Medicaid eligibility level but also just barely above the poverty line, meaning they could not afford marketplace plans. For a single adult that is an income around $21,000 annually and just more than $40,000 for a family of four. What Medicaid expansion meant for people in the gap, in a practical sense, is they no longer needed to forego basic medical care to cover rent, food, child care or other basic needs. Mothers no longer are forced to choose between a potentially life-saving mammogram and a month’s worth of groceries or new shoes for her kids. 

This is why voters passed expansion, approving it at better than 60%. Since its implementation it has only become more popular as a recent survey by Idaho Voices for Children found 73% of state residents believe Medicaid expansion should be kept as is, including 69% of Idahoans who identify as Republican.

Repeal or reform: The Idaho Legislature’s plans for Medicaid expansion in 2025

That last part is important to note as the 2025 Idaho legislative session approaches. Lawmakers should arrive in Boise next month prepared to defend the will of the people who put them into office. When lawmakers failed to act on Medicaid expansion voters took matters into their own hands. Now it is their responsibility to stand behind the will of those same voters and maintain access to life-saving care for thousands of Idahoans.

Last year what amounted to a Medicaid expansion repeal attempt was driven by out-of-state groups planting model legislation that was then introduced by Idaho lawmakers. More of the same is expected in 2025. Idahoans showed up in huge numbers last year and the bill died in committee. Hopefully, lawmakers have heard the will of the people loud and clear and won’t put health care on the chopping block again.

These out-of-state interests say they’re trying to save Medicaid. The truth is, it’s not in need of saving. It’s working just as voters intended and our friends, family and neighbors are getting the care they need when they need it. This includes the nearly 25% of expansion enrollees diagnosed with serious mental illness and nearly 80% with reportable income, meaning they are working but not making enough to afford private insurance. Repeal of Medicaid expansion would be devastating, and we simply cannot allow it to happen.

Nearly all our people work — and work hard — and many jobs simply don’t provide access to health care. Only 43% of Idaho businesses provide health insurance benefits to their employees. Many of the folks who use Medicaid expansion work in the service industry, agriculture or are young professionals just getting their careers started. Access to Medicaid allows them to gain that footing and makes sure income does not dictate ability to detect cancer early or stop an easily treatable condition from becoming much more serious and potentially deadly.

Beyond the everyday health benefits for Idaho residents, Medicaid expansion creates jobs and supports the financial wellbeing of health care providers, especially those in rural settings which absorb millions in uncompensated care costs that have been dramatically offset by Medicaid expansion.

Medicaid expansion is working for Idaho and needs to stay in place as voters intended.