Krystal Esterline is among about 600 people in Idaho with both developmental disabilities and severe and persistent mental illness who had to choose between her developmental services and her mental health services, under one of this year's Medicaid cuts. The results were disastrous; after losing her psychosocial rehabilitation services, the 22-year-old began to let people into her apartment, gave her keys out, and the police had to get involved. The young woman, whose mother died when she was 13 and who lived in more than a dozen foster homes, had been living in her own apartment and holding down a job; she moved in with her legal guardian, and then to a group home; she lost her job and is suffering from dental problems. "It makes me feel like I can't be a civilized, successful person in Idaho," she said this morning. "If you don't have insurance you can't pay for dental so you don't have good teeth. ... You don't have money to pay for your medicine so you can go on with your day. ... I don't like any of it. It just made my life harder and more stressful."

Jim Baugh, executive director of Disability Rights Idaho, said, "All 600 of those people had to make a choice. Most of those people chose their developmental services because that's what they live with day to day. ... Most of those people lost those psychiatric supports." He said, "Already we have been getting reports and calls from people who, like Krystal, their whole system of supports is collapsing because they don't have that specialized psychiatric assistance. This is something we really need to restore."

Baugh and other advocates said the Medicaid cuts imposed this year were meant to balance the budget, but now that revenues have improved they should be restored. "In a desperate move to address what we thought was a crisis in revenue, we have done terrible damage to that system of support," Baugh said. "We need to make sure we take out of the statute these temporary, desperate changes in the service system."

Former state chief economist Mike Ferguson said the low-balling of state revenue forecasts in setting the state's budget has resulted in a $103 million surplus that now is essentially "parked," awaiting being carried over into next year's budget. That money could be used instead to restore Medicaid cuts now, he said. "For every dollar that we don't spend in Medicaid, we're giving up 70 cents in federal matching money," he noted.

Sgt. David Cavanaugh of the Boise Police Department said, "What's important to me is the misleading concept that the cuts save money - they don't. They just rearrange where the money is spent." He said his department is increasingly dealing with people with serious mental illness. "If everyone thinks that these folks are just suddenly going to get better or they're just not going to be as serious with less medication and with less help, they're deluding themselves," the police sergeant said. "Ultimately when they can't cope or don't have the right support groups and can't get the medication they need, then they call 911."