Medicaid expansion saves lives, boosts economies in rural Idaho

By Kelly McGrath
Reader Contributor

As a family medicine physician in rural Idaho, I have had the privilege of caring for Idaho families for more than three decades. I have celebrated their milestones and stood by them during some of the most difficult days of their lives, helping them navigate challenging times. Many of these hardships have been directly tied to health issues, often triggered or worsened by poverty.

In 2018, Idaho voters approved expanding Medicaid coverage; and, since its implementation, I have witnessed improved health and prosperity in our rural communities. With the current proposals in the Idaho Legislature to take this coverage away from our most vulnerable citizens, our rural communities are at risk to become sicker and poorer. We cannot let this happen.

Idahoans in rural areas participate in Medicaid at higher rates than those in metro areas. They also tend to be sicker, older and poorer than our urban neighbors heightening the need for healthcare coverage.

Many of the patients I see with coverage through Medicaid are working, caring Idaho citizens who have experienced difficult medical conditions or are just living through challenging financial experiences. For these patients, Medicaid expansion is a literal lifeline. 

Medicaid expansion allows patients to receive preventive care and screenings. These tests detect conditions early when treatments are most effective and less expensive. When patients need life-saving interventions like chemotherapy or surgery, Medicaid enables them to receive that necessary care.

Recently I had a patient tell me, “Without Medicaid, I would be dead.” She was right. Last year she had a critical illness. She spent several days in an intensive care unit and underwent surgery. Fortunately, she survived and is now thriving. If she had put off going to the emergency room, as so many people like her do when they don’t have insurance, her story could have had a different ending.

Medicaid expansion also strengthens the economic health of rural communities. When people who are injured or sick need access to medical care and do not have sufficient resources, they often incur medical debts. Even modest debt can put rural Idaho families into a financial tailspin. This makes entire rural communities poorer by stifling economic growth. 

Families struggling with medical debt are less likely to invest in businesses, make purchases or participate in the local economy — key drivers of rural prosperity. Worse yet, those in debt often delay further medical care, leading to more severe health issues and an even deeper financial spiral. Medicaid expansion keeps both individuals and their communities healthier and more financially stable.

Taking Medicaid expansion away means returning to a harmful reality where tens of thousands of Idahoans live in the coverage gap. They won’t have health insurance through an employer. Their wages will be too low for them to qualify for tax credits to buy coverage. They also will earn too much to qualify for traditional Medicaid. Without an affordable coverage option, they will be forced to delay or forego medical screenings and necessary care. If an emergency medical need comes up, they may have to choose between their health and financial ruin for their family. That outcome impacts all of us.

I dream of a future where all Idaho citizens are financially prosperous and healthy. Until that time, we are wise to protect our Idaho neighbors, friends and families when they fall on hard times. The Idaho voters recognized this when they approved Medicaid expansion. The Idaho Legislature should honor the will of the voters and protect Medicaid expansion.

Dr. Kelly McGrath is a family medicine physician practicing in Orofino, Idaho.