TWIN FALLS • When the U.S. Supreme Court upheld the health care reform law earlier this summer, states were presented with several questions.
Specifically, the Patient Protection and Affordable Care Act requires states to decide whether or not they will expand their Medicaid eligibility requirements.
What states were not given was information on how to make the best decision.
Anticipating a need for better data on a possible Medicaid expansion, the Idaho Department of Health and Welfare requested an analysis of newly eligible Medicaid individuals in April.
The report was released Thursday just in time to be distributed to Gov. C.L. “Butch” Otter’s Medicaid expansion workgroup before it meets later this month. The 15-member workgroup has been tasked with evaluating the impact of expanding Medicaid and must submit their recommendations to the governor by Nov. 1.
According to the report, close to 111,500 additional Idahoans would qualify for Medicaid if the state expanded its eligibility. Close to 10,000 of those newly eligible would be from the Magic Valley, primarily from Twin Falls County.
Idaho’s Medicaid federal-state partnership offers medical insurance to almost 235,000 low-income people. Close to 70 percent of those enrolled are children from low-income families but also covers people with disabilities, low-income women who are pregnant and low-income elderly.
Expanding Idaho’s eligibility requirements would provide insurance coverage for low-income adults up to 138 percent below the federal poverty line. Currently, Idaho only allows adults – who are not disabled or elderly — to qualify for Medicaid if they have children and an income less than 20 percent of the poverty level. For a family of four, that would be close to $4,500 a year.
The report also showed that four state programs could shift as many as 47,000 individuals to be newly eligible for Medicaid. This includes 35,000 individuals receiving care from Community Health Centers, 6,000 individuals relying on the state’s medical indigent services and 4,300 individuals receiving mental health services from the state.
Under the health care reform law, the federal government would pay 100 percent of the state’s expansion costs for three years. By 2020, the federal government would reduce funding to 90 percent.
According to the report, Idaho doesn’t face a deadline to notify the federal government when it will begin a Medicaid expansion. The state also has the option to opt out of the expansion at anytime without penalty.
Overall, the report urged Idaho leaders to wait to make a final decision until the federal government releases more guidelines on Medicaid expansion, which should be after the November election.
If Idaho does choose to expand, the report recommended implementing changes in 2014. By doing so, the state would have three years of full federal funding but also allow Idaho to opt out of the program by 2016.
Idaho’s Medicaid expansion workgroup will meet Sept. 27 in Boise. Live audio of the event will be available at www.idahoptv.org/leglive.