Opinion: Medicaid vs money

During the 2023 interim, I served on the Medicaid Managed Care Task Force and was charged to study the existing Medicaid managed care programs in Idaho and other states to determine the most successful and cost-effective means of implementing a managed care organization (MCO). We narrowly decided to recommend a continued investigation of Medicaid with the main conclusion being, “The task force…recommends that the Legislature provide more oversight of Medicaid through the creation of a Medicaid Legislative Review Panel.” My vote helped buy us more time to do thorough research before doing a major overhaul of the Medicaid program.

The Idaho GOP is not satisfied with this conclusion, and I expect we will see a revival of their attempts to switch Idaho to an MCO system this legislative session. I have said it before and I will say it again, MCO is just a glorified name for allowing a private healthcare insurance company to run the Medicaid system for us.

Idaho Medicaid is a government-run program that not only provides health insurance to adults and children with limited income and resources, but it is also a sizable investment of over $4 billion for healthcare paid to local businesses throughout the state. We have a legal and moral duty to take care of Idaho’s children and adults who have the need. Idahoans are the present and future of our great state through all of the great things they have contributed and will contribute to our society and economy. A large part of my commitment to Idaho residents is providing them with affordable and accessible healthcare, which means Medicaid should remain under the control of the state. Therefore, I am against the MCO model.

Instead of giving Medicaid the proper funding, Idaho GOP legislators want to gut Medicaid and leave thousands of Idaho residents without health care. According to Kyle Pfannenstiel at the Idaho Capital Sun, approximately 57,000 children were removed from Idaho Medicaid last year. This means that Idaho is tied for “the highest rate of children removed from Medicaid” and this is rightly causing alarm amongst federal regulators.

It’s not just children being removed from Idaho Medicaid. According to another article by Kyle Pfannenstiel at the Idaho Capital Sun, approximately 77,000 people were removed from the program without solid proof that they were ineligible for it. Later 13,000 of them got back on it. This shows that there are likely many people who are eligible for Medicaid who have been removed in an attempt to save some money.

This is not what Idahoans want. Idahoans want Medicaid to be available and have demonstrated that by their voting to expand the program several times over the past few years. According to a poll done by Idaho Voices for Children in July 2023, 67% of voters support Medicaid expansion.

In the most recent report from the Idaho Department of Health and Welfare, they make it clear that MCO is not the way to go as “Value care organizations (VCOs) are responsible for controlling costs and improving health outcomes of their patients.” Why would we upheave a system that is already working?

Medicaid indeed costs money, however, I believe that the investment in people to be able to stay in Idaho and contribute to the state’s greatness is worth the costs. Part of that involves ensuring that everyone has access to affordable healthcare. It is clear to me that VCO is the way to cut costs and improve the quality of care. I hope you will also speak up and ask all legislators to join me in supporting VCO.

We have already held a print hearing on a bill to repeal Medicaid Expansion through technicalities, HB 419. This is simply bad legislation that will increase the workload on an embattled Idaho State Health and Welfare Department, causing them to manage more waiver processing and biannual eligibility redeterminations. It will also require Health and Welfare to cap expansion enrollment at 50,000 at a maximum. This is being pushed by out-of-state “think tanks” that think that they can tell the voters what to do. I want to assure you that I will defend the will of the voters and work to ensure that Medicaid Expansion continues to help Idaho’s most vulnerable workers and their families.