It may take the political equivalent of a crowbar to expand Medicaid in Idaho, but some are trying

When Congress first offered Medicaid expansion to the 50 states, the Idaho Legislature didn't just turn down the opportunity; it ignored the offer completely. No legislation, no official hearings, little talk. Medicaid expansion was royally snubbed.

As a result of our state's stubborn refusal to recognize the need for a better health care plan of action, millions of dollars have been lost over the last five years to Idaho's medically needy — and to the Idaho economy.

Although we pride ourselves on being sturdy stock, we Idahoans are not any healthier than the average American. We are just more obstinate — and more Republican — as reflected in the Idaho Legislature's refusal to even discuss accepting more federal help for the folks who can't afford to be sick.

Finally, this January, after five years of the silent treatment, Idaho has not one but two health-care options on the table. One is an initiative petition that, if passed, would add Idaho to the list of states signing on to Medicaid expansion. The other is a waiver strategy that seeks approval from two federal agencies, which will need legislative approval to go forward. Both options are positive and forward-looking.

Luke Mayville, Ph.D., a native of Sandpoint and now a postdoctoral student at Columbia University, has started a new movement, Reclaim Idaho. In the summer of 2017, Mayville and his hardworking lieutenants, Garrett and Emily Strizich, commandeered a 1977 camper festooned with a large, green "MEDICAID FOR IDAHO" sign and drove it all over the state. Starting with Bonners Ferry in the north, they traveled from city to city, interviewing people up and down the streets about their medical concerns.

The Medicaid for Idaho bus received a friendly reception in every one of the 20 cities visited. Idahoans in general don't consider health care a partisan issue. Across the state, Republicans, Democrats and Independents alike agreed with the Reclaim Idaho volunteers on the need to bring additional Medicaid to the people of Idaho.

This month, Reclaim Idaho members filed an initiative petition to put Medicaid expansion on the November 2018 ballot for the voters of Idaho to decide if our state should join the 32 other states who accept the additional federal dollars.

The petition simply states that the state health plan will be amended to expand Medicaid to cover Idahoans under 65 years of age whose income is 133 percent of the federal poverty level or below. That's a $20,030 a year income for a single person, or $33,941 for a family of three.

The initiative process is a last resort for a frustrated public to fall back on when the legislature fails to act. Over the years, the Idaho legislature has made it harder and harder for activists to get an issue on the ballot. Idaho's initiative law now requires verified signatures from 6 percent of registered voters in 18 legislative districts in the state. The initiative will need an estimated 56,000 signatures to make it onto the November 2018 ballot.

That's a tall order. Reclaim Idaho and its trusty volunteers have just four months to gather signatures. The big task is connecting those willing signers, who must be registered voters, together with petition carriers.

The economic impact of millions of medical dollars is also significant. Our local hospitals cannot turn away anyone with a medical crisis who is delivered to them, regardless of the patient's ability to pay. Even though Medicaid doesn't always cover the complete cost of a procedure, Medicaid dollars are a significant portion of any hospital's budget. In the case of rural hospitals, Medicaid dollars keep the hospital doors open.

We have learned that Idaho has the fastest growing population in the country, and that Coeur d'Alene and Post Falls are the fastest growing cities in this fastest growing state. In addition, a majority of the people moving in are 55 and older, moving from California or Washington to escape crowding and the high costs of living.

These older people moving into the state will need more medical care. They may bring their Medicare with them, but they will need doctors to cure their ills, more nurses and support staff. Idaho is 49th in the nation in doctors per population.

The waiver requests that are now before Idaho legislators are two-pronged. One prong would allow an individual or family with incomes under 100 percent of the federal poverty level to receive deductions and tax credits to make the policy affordable. The second prong would allow individuals with specific expensive medically complex conditions, such as cystic fibrosis, to receive treatment covered by Medicaid for the duration of their illness.

Idaho legislators are fully aware that the initiative petitions are circulating in every one of their legislative districts. That's a healthy nip at their legislative heels. It would also help for them to receive messages of support for the waivers from their constituents.

I urge every Idahoan who's registered to vote to sign the petition to expand Medicaid in Idaho. Better yet, download a petition and get 12 friends to sign with you.♦

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