“We have to do something about Medicaid before we can go home.” This is the mantra of members of the Idaho Legislature, primarily from those who are still stinging from the fact that the voters took control of Idaho’s health coverage gap problem after years of legislative inaction, and from others who fail to question this legislative groupthink. This Thursday, March 14, Idaho physicians will gather at the Statehouse to tell legislators they have one thing to do related to Medicaid expansion, pass the Medicaid budget.

The new Medicaid law, passed by 365,107 Idahoans, directed the State to submit the necessary paperwork to allow Idaho to expand Medicaid to those Idahoans who fall in the health insurance coverage gap. The plan was completed and submitted in February. Check. Governor Little has already proposed the funding mechanism, which was approved unanimously by the joint budget committee. Check. The Senate already approved the budget. Now it needs to be passed by the House and they can check that box and go home having fulfilled their legislative duty when it comes to Medicaid.

Yet legislators feel the need to complicate the issue. They are not exactly sure what they want to do but they are convinced they must do something. Instead of proposing legislation with specific health policy objectives, they have cobbled together a mishmash of bureaucratic hurdles to Medicaid coverage. The main criteria for inclusion in the current proposal is based on how many votes each idea might garner, not whether it’s good public policy. After weeks of private negotiations among legislative leadership, changes to Medicaid are being made for a purely political reasons: proving to the most intemperate factions of their base they did something about Proposition 2.

Rather than thinking about the needs of Idahoans and developing a plan specific to their constituents, they’ve placed their focus on scanning through Medicaid waivers from other states picking and choosing their favorite obstacles. So-called fiscal conservatives are inexplicably willing to consider policies that add unnecessary costs if it fits their ideology. Some want to inject expensive work reporting requirements, even though voluntary work education and training programs have proven less costly and more effective in helping people move off of government programs. As a physician, I work hard to make sure the medicine I prescribe to my patients is something they need. Legislators should do the same when it comes to policy making. All legislators should want to protect Idahoans from unnecessary government spending and bureaucracy.

Every year for the past 4 years, physicians have met with legislators in March asking them to do something about Medicaid expansion. This year, instead, we will ask them not to complicate the issue by increasing government red tape and wasting taxpayer dollars. We are calling on all legislators to implement a clean Medicaid expansion and to stop engaging in wasteful political battles. Legislators should complete the assignment given to them by the voters of Idaho, check the box and go home.

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Courtney Swantek is a medical student at The University of Washington, Idaho Campus.


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