Advocates highlight Idahoans' health care access under Medicaid expansion in short film

Since Idaho voters chose to open up Medicaid eligibility to more people in 2018, the expanded program has faced scrutiny over its cost versus cost-savings. Some of this debate may be renewed with new lawmakers voted in during this year’s election preparing to gather for the 2025 legislative session.

There are now around 100,000 Idahoans who have health coverage under Medicaid expansion — including Pocatello Resident Patrick Murillo, a prostate cancer survivor and member of the Shoshone-Bannock Tribe, and Boise resident John Barnes, who uses the coverage to access services related to substance abuse disorder recovery.

These residents are featured in a short film “Idaho Supports Medicaid: In Our Words,” which was created by the American Cancer Society Cancer Action Network (ACS CAN) and Voices for Children. The film is set to premiere in Boise at 5:30 p.m. Wednesday at Treefort Music Hall.

“Medicaid is a really good program, and sometimes, you get too deep in all the more politicized language around it, it’s easy to lose sight of what’s really at stake,” said Meredith Wheeler, senior campaigns manager on state and local Medicaid Campaigns with ACS CAN.

The expansion program, which extended eligibility to those who couldn’t afford health care under the Affordable Health Care Act but didn’t quite qualify for traditional Medicaid coverage, went into effect in 2020. The past few legislative sessions, bills have been brought forward in the Legislature to repeal or limit the program.

“There is still an effort out there to repeal but also there's also efforts to put restrictions on Medicaid expansion, and so (we are) just trying to impart on the Idaho Legislature and the governor that this is a program that works and that’s helping Idahoans,” said Randy Johnson, Idaho government relationship director at the cancer action network.

Wheeler and Johnson both emphasized that the American Cancer Society’s advocacy arm, the cancer action network, is invested in protecting Medicaid expansion because of the impact that expanded coverage has on improved preventative cancer screening as well as access to treatment, both of which improve patient and public health outcomes.

The cancer society estimates that more than 11,000 Idahoans will receive a first-time cancer diagnosis this year. The short film also features the stories of Dr. David Johnson, who practices gastroenterology at Kootenai Health in Coeur d’Alene.

“(Johnson) is really seeing a lot of rural individuals who live in northern Idaho, they come to Coeur d’Alene to receive treatment from, in some cases, pretty far away,” Wheeler said. “... I think he has a really good perspective on, at the individual level, a cancer screening may not rise to the top for a family who’s trying to figure out how to pay their bills and get by on a daily basis. But in the big picture of public health, it is so incredibly important that folks get those early screenings.”

The rising costs of Idaho’s entire Medicaid program have been a major point of debate during recent legislative sessions. Last year, an interim committee evaluated switching to a managed care approach to help mitigate costs, and this year, a task force called the Medicaid Review Panel is in the process of looking in-depth at Medicaid’s contracts to potentially rein in spending. The state-covered portion of Idaho’s Medicaid program has largely leveled off in the past couple of years, but the federal portion has continued to rise, due to a number of factors, including population growth, the pandemic, and high-utilization users with more complex needs.

Several lawmakers have questioned Medicaid expansion and if its costs and savings were as good as advertised by advocates of the 2018 ballot initiative. A bill was introduced last session that would have repealed Medicaid without adherence to a number of strict conditions, some of which were unlikely to be met.

The sponsor, Rep. Jordan Redman, R-Coeur d’Alene said at the time, "I believe that we can all agree that it’s important to have a healthy and sustainable welfare program within the state of Idaho for its most vulnerable and in-need citizens that isn’t abusing or misusing tax dollars but stewarding them well.”

The bill died 8-5 in the Health and Welfare Committee amid overwhelmingly negative testimony.

Lawmakers, health advocates, and members of the public were invited to the Boise screening of the short film, and there’s plans in the works for a separate showing with just legislators during the session, Wheeler said.

“I think there’s really no scenario where hearing from people individually about how this has changed their lives or what a difference this has made is a bad thing,” Wheeler said, “So it’s part of the conversation, anticipating that we may see threats or some dialog about the Idaho Medicaid program in general as well as the Medicaid expansion, specifically.”