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In the world of social programs, Medicaid is one of the hardest to understand. It’s something of a catch-all program for low-income people, covering broad and divergent needs. Included are healthy children and adults with eligible dependent children, people with disabilities or special health needs, and the elderly. Eligibility is income-based and it varies according the category of qualification for the program.During the state’s 2011 fiscal year, more than three quarters of the funding allocated to the Department of Health and Welfare’s budget went to Medicaid. The program received about $1.55 billion in federal and state funding, with 74 percent of those dollars coming from the federal government.Enrollment in Idaho’s Medicaid program has grown substantially in recent years. The average monthly Medicaid enrollment was fairly stable between 2006 and 2008. It grew by about 3.5 percent. But in the last three years, the program’s enrollment has grown nearly 21 percent. Ballooning from about 185,000 in 2008 to 228,897 in 2012.

Idaho's 2013 Medicaid Rolls At Highest Level Yet

Medicaid
Data: Idaho Dept. of Health and Welfare | Chart: Emilie Ritter Saunders

The number of low-income Idahoans on Medicaid increased 3.5 percent in 2013, a figure the Idaho Department of  Health and Welfare says marks a slow-down in growth of the program.

On average, 236,352 Idahoans were signed up for Medicaid each month of 2013. That's the highest average monthly enrollment the state has ever recorded.

The department's annual Facts, Figures and Trends report says Idaho's total Medicaid bill in 2013 was $2.02 billion. The federal government pays 66 percent of that cost, while Idaho's general fund pays 24 percent.

A year ago, the Idaho Department of Health and Welfare estimated more than 70,000 additional Idahoans would sign up for Medicaid as the Affordable Care Act went into effect. 

Since then, the agency has reduced that estimate to 35,000 additional Idahoans. These are people who've likely always been eligible for Medicaid, but have never signed up and could be encouraged to do so once the health law's individual insurance mandate has been in effect for a while.

On Wednesday, a panel of Idaho lawmakers again rejected a proposal to expand Medicaid coverage to Idahoans at or below 138 percent of the federal poverty level. According to the Kaiser Family Foundation, Idaho is one of 19 states that have rejected Medicaid expansion, six states are still considering expansion.

The Health and Welfare department estimates 77,000 Idahoans will fall into a so-called health insurance coverage gap, where they aren't eligible for Medicaid and don't qualify for a subsidy on the newly-created health insurance exchange.

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