More Idahoans need taxpayers to cover unpaid medical bills. Could Medicaid expansion help?
Costs and government overreach are the main reasons state lawmakers cite for resisting expansion. The most recent analyses commissioned by the state of
Meanwhile, economists have predicted
County officials of both political parties have talked about how Medicaid expansion could help rein in costly indigent services.
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"That might be an opportunity to reduce or eliminate the levy for that program ... a savings to the taxpayer,"
Even if voters pass the initiative, though, state lawmakers or the governor could delay or block Medicaid expansion.
That's exactly what's happening in
Cost vs. health
According to the
Many of those people are in what's known as the "Medicaid gap." That means they make too much money to qualify for either Medicaid or insurance subsidies on the state-run health exchange, but not enough to afford private insurance.
With access to Medicaid, people would be less likely to use emergency rooms for health problems that should be handled through primary care doctors, or from ignoring those problems until they turn into true emergencies, said
"They're still the working poor, but their health care will be covered in a much better way and more fundamental way," he said.
Milliman in 2016 projected 10-year net costs of almost
The institute acknowledges that more Medicaid money likely would reduce the state's and counties' costs of covering medical bills patients can't, but it doesn't put a number to them.
Milliman predicted state and county savings would offset most of the expansion's
The 2016 study wasn't Milliman's first. In 2014, the firm concluded that Medicaid expansion in
The state has authorized Milliman to update its projections this spring. Results should be ready in June,
Who pays what?
Every year in
The department sends bills that don't qualify for federal assistance to the counties, which investigate patients' ability to pay. County commissioners vote on whether to declare patients medically indigent. If they make that determination, their counties take on responsibility for the unpaid bills.
Counties pay the first
Counties put the responsibility for collecting payment back on the hospitals if they determine patients are not medically indigent. Hospitals often write off those bills as charity care.
Property taxes pay medical bills
Last year, counties in
Expanding Medicaid would cover some unpaid medical bills, potentially reducing county property taxes and freeing up budget space for state lawmakers.
Most Medicaid money would come from the federal government, with the state covering the remainder.
'It will have an impact'
Milliman's most recent study followed three straight years of declines in county and state costs for unpaid medical bills. Reality has shifted since then.
The CAT fund will spend
The loss of the mandate likely will lead to more uninsured people, Christensen said. That means more hospital bills will go unpaid, leaving
Like many county leaders, Christensen thinks Medicaid expansion could counteract this trend.
"If it is implemented, it will have an impact," he said.
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