By Fred Birnbaum, Vice President of the Idaho Freedom Foundation
On November 6, Idaho voters will decide whether to expand Medicaid via Ballot Proposition 2.
Please consider the following reasons why rejecting Medicaid expansion is in the best interest of all Idahoans, including senior citizens.
Medicaid currently provides long-term care for eligible adults over 65 years of age, including Home and Community Based Services. In Idaho, these services are provided by Medicaid’s Coordinated Medicaid Plan.
This plan consumes about a quarter of the Medicaid budget and includes the following services: Personal Care Services, Adult Day Health, Adult Residential Care, Specialized Medical Equipment & Supplies, Non-Medical Transportation, Attendant Care, Chore Services, Companion Services, Consultation, Dental Services, Home Delivered Meals, Homemaker Services, Environmental Accessibility Adaptations, Personal Emergency Response System, Respite Care, and several other services.
These services are part of the traditional Medicaid program.
Other recipients of traditional Medicaid services include disabled adults and children along with pregnant women from low income families.
However, Medicaid expansion would extend coverage to adults without disabilities, under the age of 65, the majority of whom are not providing care to either children or elderly adults. These are working-age adults with lower incomes. If they choose to work, they are eligible for taxpayer-subsidized health insurance coverage on the Your Health Idaho healthcare exchange.
By expanding Medicaid, resources currently going to the truly needy and elderly will be redirected to able-bodied, working-age adults. If you have heard that Idaho can accommodate a surge in Medicaid enrollment, consider the following.
Medicaid expansion is costing “expansion” states far more than was originally projected. When reviewing evidence from states that have expanded Medicaid, we see that on average enrollments and costs are more than double what was initially projected. Kentucky, which faces a $300 million shortfall due to Medicaid expansion, is seriously considering rescinding it.
Medicaid expansion is sold as a way to help our neighbors. Not mentioned is the following data, which makes the opposite case. According to a March 6, 2018 report by the Foundation for Government Accountability, “Since Obamacare expansion began, at least 21,904 individuals on Medicaid waiting lists have died in expansion states.” These individuals were on Home and Community Based Services (HCBS) waiting lists. These services are essential to elderly Idahoans.
Finally, many news stories assert that Medicaid expansion will save us money, because expansion costs will be offset by reducing other state and local medical expenses for indigent patients. However, the data we have suggests, to the contrary, that expansion will be a net cost to Idaho. The July 19, 2018 Milliman actuarial report on Medicaid expansion projects that expansion will cost the state $105.1 million—and given the experience with Medicaid forecasting in other expansion states, we can expect costs to be much higher.
Medicaid exists for a purpose: to provide healthcare for those who are most vulnerable, including Idaho’s senior citizens. Expanding Medicaid to able-bodied working-age adults will jeopardize the future of the program for those who need it most. ISI