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Medicaid expansion in Idaho

Co-founder of Reclaim Idaho Luke Mayville talks in August 2018 in Twin Falls about the 1989 Airek camper he used while promoting the measure around the state.

Last June, the state of Arkansas enacted “work requirements” for Medicaid recipients in an effort to incentivize people to work.

It was a failed experiment. Recent studies by the Kaiser Family Foundation found that between June and November 2018, nearly 17,000 people lost Medicaid coverage—and so the “Medicaid gap” continues to exist in Arkansas in spite of Medicaid expansion.

And here’s the thing: It is estimated that the majority who lost coverage were working; they merely failed to file the correct paperwork. They were victims of red tape.

Here in Idaho, where citizens recently voted by a landslide to enact Medicaid expansion, we have a chance to learn from Arkansas’ mistakes.

Newly elected Gov. Brad Little recently suggested that Idaho lawmakers should honor the will of the voters, but that Medicaid Expansion should be implemented “in an Idaho manner.” Many interpreted Little as suggesting that Idaho should follow Arkansas and enact “work requirements” for Medicaid recipients.

The truth is that so-called “work requirements” are not the “Idaho” way; they are the Arkansas way. They failed in Arkansas and they would surely fail in Idaho.

Most will agree with Gov. Little that people should be incentivized to become more productive, to make more money, and to move off of the Medicaid rolls. But the best way to achieve this goal is to implement Medicaid expansion as it was written and without modifications.

A recent report by the Ohio Department of Medicaid found that Medicaid expansion without work requirements has incentivized people to start working and to be more productive. Since 2013, when expansion was enacted, 290,000 Ohio recipients have transitioned off of the Medicaid program because they found a job or received a raise.

Over 83 percent of Ohio’s employed Medicaid recipients reported that the program helped them hold down jobs. Thousands of workers obtained treatment for ailments that would have otherwise barred them from working.

Idaho Gov. Little has said that our Medicaid safety net needs “springs” that incentivize people to work and to become self-reliant. The Ohio experience proves that the most effective spring — the most effective incentive — is reliable health coverage. So-called “work requirements” don’t work. They might make for a good political soundbite, but they don’t have the promised effect of getting people back on their feet. Instead, they operate as barriers to coverage that make people less healthy and therefore less productive.

If our lawmakers are willing to put soundbites aside and prioritize the health and productivity of our people, they will reject so-called work requirements. The true Idaho solution is to implement Medicaid expansion exactly as it was written.

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Luke Mayville is the co-founder of Reclaim Idaho, the organization that launched the petition drive to expand Medicaid in Idaho.


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