What should Idaho do about Medicaid expansion?

Interview

The Medicaid system needs to be reformed before we can consider expansion. The system is structured to encourage continued reliance on the program. Once on Medicaid, recipients are forced to choose between earning more and losing their benefits, or declining more work and staying on the program. This same thing would still happen even if we increased the maximum income limit to make more people eligible. If states were allowed to adopt an approach that allowed recipients to pay a greater share of their coverage as their income increased, then low income Idahoans wouldn't have to choose between self-sufficiency and Medicaid coverage. The Obama Administration, however, has been unwilling to accept anything short of wholesale entitlement expansion; the exception being the Arkansas plan, which has exposed that state to significant fiscal risk. If reform were possible, then the long-term savings to county indigent care funds and the economy in general could be beneficial; without reform we'd only be contributing to ballooning deficit spending. Until there is reform, I can't support a Medicaid bill in Idaho.

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