Medicaid works — let’s keep it that way

By Hillarie Hagen
Reader Contributor

Idaho Medicaid helps our kids grow into healthy adults. It also helps adults stay healthy so they can take care of their families. Idahoans know how valuable this is: 75% have a favorable view of Medicaid and 80% oppose cuts. Unfortunately, proposed funding reductions and other schemes could cut life-saving services to our families, friends and neighbors.

For more than 50 years, Medicaid has been funded by a partnership between the state and federal governments, where both have skin in the game. This arrangement has successfully covered decades of critical care.

Medicaid means pregnant women receive prenatal care and delivery services that give babies a healthy start. It covers screenings for babies and toddlers that catch developmental issues early, when interventions are most effective. 

Because of Medicaid, Idahoans can access life-saving medication like insulin, asthma inhalers and blood pressure medicine. Youth and adults receive mental health treatment. Idahoans can access preventive care, including screenings that detect cancer early. Seniors on fixed incomes receive nursing home care. Children with disabilities receive therapeutic services. Adults with disabilities receive assistance that allows them to live their most independent lives.

Medicaid expansion makes all that even more possible. Idahoans who had previously fallen into the coverage gap — earning too much to qualify for traditional Medicaid, but not enough to qualify for tax credits that make private coverage affordable — can now enroll. Medicaid expansion has been proven to save lives and keeps 88,000 Idahoans out of the coverage gap today. Idaho voters passed Medicaid expansion with overwhelming support as a ballot initiative, and 73% of Idaho voters want it kept as-is today.

Both a challenge for and a strength of Medicaid is that it is extremely lean and very efficient. Medicaid reimbursement rates are so low that providers sometimes can barely cover costs. Of the state’s Medicaid budget, 95% goes directly to medical care, a much higher rate than any private insurer.

Skimping on this critical investment takes a toll. It can be hard for patients to find providers that accept Medicaid. And Idaho’s income eligibility levels are already the lowest in the country for kids and pregnant women.

This context makes it all the more worrisome when we hear about proposals floating around Congress to cut what is already bare bones. Medicaid “block grants” and “per capita caps” are funding cuts by another name. Cuts to the federal contribution to Medicaid would directly impact patients. Potential new paperwork requirements designed to take away health care are unacceptable.

When Medicaid funds are at risk, the most vulnerable are at risk. The first thing on the chopping block is usually home- and community-based services that help Idahoans with disabilities to stay in their homes. These are services the state chooses to cover, when the alternative — living in an institution — is more expensive and the last resort for those who want the freedom to live independently.

Cutting people from our already restrictive eligibility requirements would cause our uninsured rates to skyrocket. As Idahoans face a rising cost of living, families may be forced to forego health care altogether until it becomes an emergency, resulting in high medical debt and risk of bankruptcy. This leads to uncompensated emergency care, which drives up health care and insurance costs for everyone — including employers. 

This is why Idaho’s business community has been staunchly in support of Medicaid expansion.

Shortchanging Medicaid shortchanges our fellow Idahoans and our future. We must call on Idaho’s Congressional delegation to reject cuts that harm Idahoans. Together we can protect Idaho Medicaid for generations to come.

Hillarie Hagen is a senior policy associate with Idaho Voices for Children. She leads the largest state health advocacy and policy network in Idaho focused on increasing access to health coverage and care for children and families. She is an Idaho native and a Boise State  University graduate.