Eye on Boise: Lawmakers hear of Medicaid expansion’s upside

BOISE – Idaho’s House and Senate Health and Welfare committees heard rather stunning figures Friday, including this one: A University of Idaho economist estimates that Idaho’s economy would get a $9.2 billion boost over the next 10 years, if Idaho opted for Medicaid expansion this year.

The state budget would save $649 million, county property taxpayers would save $478 million, and the new federal funds coming into the state would generate $614 million in new state tax revenues and economic activity. Subtract program costs and the net savings to the state budget plus new revenue comes to $699 million.

Lawmakers asked state Health and Welfare Director Dick Armstrong if his department is ready to act, should the state decide to go that route. “We are ready to act on the eligibility side,” he said. “We’ve been working on that project through Medicaid eligibility for over a year.”

The two committees gathered for a joint meeting to hear presentations on HB 308 and 309 – eliminating Idaho’s county indigent and state catastrophic care fund programs and expanding its Medicaid program instead, largely at federal expense. The county and state programs are now funded 100 percent by local county property taxpayers and the state general fund; the Medicaid expansion would be funded 100 percent by federal funds for the first three years, then phased down to 90 percent.

Rep. Tom Loertscher, R-Iona, who served on the House committee for 24 years but got his start on the issue as a county commissioner in the 1970s, told the committees, “I’ve been around this for what seems to me as forever. … I believe it was about 1976 when the counties were put on the hook for medically indigent folks in the state. And at first, the numbers weren’t very big. … Very rapidly, though, as I took office in 1979, things began to escalate a lot.”

Doing away with the county/state program would save Idaho property taxpayers nearly half a billion dollars over the next 10 years, Loertscher told the committees. “This is a program that was put on counties that’s just becoming unbearable. It’s consuming more and more of commissioners’ time as well as more employees to keep up with the demands.” In addition, the latest estimates show the state, too, would save tens of millions.

“We’re at kind of a crossroads right now, and we’ve got to make a decision about this,” Loertscher said. “I would be a strong advocate of repealing the counties’ indigent responsibilities. It is direct property tax relief.”

Sen. Dan Schmidt, D-Moscow, said, “Given that pressure of time, I’m going to propose a motion, that HB 309 be sent to the floor of the House with a recommendation from this committee for passage.”

Rep. Fred Wood responded, “Senator, my heart is with you, however I’m going to have to tell you I’m going to rule this motion out of order.” Friday morning’s meeting was “noticed up as an informational meeting only, and no testimony was taken,” Wood said. “We simply cannot conduct business when the public has not had an opportunity to weigh in. I understand your frustration … but at this point in time, Senator, that motion is out of order.”

Rep. John Rusche, D-Lewiston, asked, “Is it the intent of the chair to have a real working hearing on these bills?” Wood said, “Are you talking about in the next week?” Rusche responded, “I’m talking about this year.” Wood said, “At this point in time, Representative, a decision has not been made by the chair with respect to that.”

After the meeting, Schmidt said, “There has been a lot of effort put forward. … I think it’s doable, and I think it’s doable this year. It’s just going to take some effort – and probably courage.”

Later on Friday, House Speaker Scott Bedke offered an answer of his own: “I think it’s an important issue that the state needs to take a look at,” he said. “I think having those bills in the public domain over the interim can accomplish that. I am not going to get out ahead of the governor’s office on that issue. At first blush it appears there could be significant property tax relief to the whole state – not just personal property tax, but property tax for everybody. We ought to look at that.”

However, Bedke said, “We are going to be done by Friday, and I don’t think we can give that issue the thorough public vetting that it needs between now and then.

“They have my full attention, because it seems to offer very, very significant property tax relief.”