Recently, Sen. Jim Risch has repeated the Republican mantra, earlier heard from our own governor, that the state of Idaho cannot afford health care reform because of the additional "burden" of Medicaid expansion.
Let me give a different view, this one supported by the actual language of the bill.
The current Senate bill, on which Sen. Risch was debating, has the following provisions for Medicaid funding:
The current federal Medicaid matching rate (FMAP) will continue through June 2011. For those of us in Idaho, that means that the federal share is 80 percent and the state share is 20 percent.
Medicaid coverage expands to 133 percent of the federal poverty level. That would indeed make about 160,000 Idahoans newly eligible for Medicaid. The vast majority of those people are low-income adults without employer coverage.
From 2014, when the expansion takes effect, through 2016, the federal match on these citizens would be 100 percent. There would be no additional state general funds involved for that coverage. From 2017 on, the feds would cover 95 percent of the cost of this new coverage. In a report to our Legislative Healthcare Taskforce, the nonpartisan National Council of State Legislatures estimates that the state share of the Medicaid coverage change is $139 million, 2014 through 2019, or an average of $23 million over the six years.
And while that cost is nothing to sneeze at, we are currently spending $45 million (in 2010) for county indigent care and in state general funds for the CAT (catastrophic) reinsurance fund. Almost 80 percent of the CAT fund cases would qualify for Medicaid coverage under the Senate bill, with an annual reduction in county and general fund expenses of about $36 million.
A little simple analysis shows that we could save the taxpayers of Idaho at least $13 million each year. And since the cost of health care is increasing at 7 percent to 9 percent annually, the real savings is likely more. And wouldn't commercial health insurance premiums likely decrease if there was not so much "cost shift" by hospitals and other providers? Overall, the financial aspects of the Medicaid changes of the current Senate bill appear beneficial to the state of Idaho in spite of what Sen. Risch may believe.
For those who wish to review this analysis, the NCSL brief to the state legislatures is a good start.
Rusche is a pediatrician who represents Nez Perce County in the Idaho House of Representatives. He serves as leader of the House Democrats. This op-ed was sent to newspapers statewide and appeared today in the Post Register.
Let me give a different view, this one supported by the actual language of the bill.
The current Senate bill, on which Sen. Risch was debating, has the following provisions for Medicaid funding:
The current federal Medicaid matching rate (FMAP) will continue through June 2011. For those of us in Idaho, that means that the federal share is 80 percent and the state share is 20 percent.
Medicaid coverage expands to 133 percent of the federal poverty level. That would indeed make about 160,000 Idahoans newly eligible for Medicaid. The vast majority of those people are low-income adults without employer coverage.
From 2014, when the expansion takes effect, through 2016, the federal match on these citizens would be 100 percent. There would be no additional state general funds involved for that coverage. From 2017 on, the feds would cover 95 percent of the cost of this new coverage. In a report to our Legislative Healthcare Taskforce, the nonpartisan National Council of State Legislatures estimates that the state share of the Medicaid coverage change is $139 million, 2014 through 2019, or an average of $23 million over the six years.
And while that cost is nothing to sneeze at, we are currently spending $45 million (in 2010) for county indigent care and in state general funds for the CAT (catastrophic) reinsurance fund. Almost 80 percent of the CAT fund cases would qualify for Medicaid coverage under the Senate bill, with an annual reduction in county and general fund expenses of about $36 million.
A little simple analysis shows that we could save the taxpayers of Idaho at least $13 million each year. And since the cost of health care is increasing at 7 percent to 9 percent annually, the real savings is likely more. And wouldn't commercial health insurance premiums likely decrease if there was not so much "cost shift" by hospitals and other providers? Overall, the financial aspects of the Medicaid changes of the current Senate bill appear beneficial to the state of Idaho in spite of what Sen. Risch may believe.
For those who wish to review this analysis, the NCSL brief to the state legislatures is a good start.
Rusche is a pediatrician who represents Nez Perce County in the Idaho House of Representatives. He serves as leader of the House Democrats. This op-ed was sent to newspapers statewide and appeared today in the Post Register.
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