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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.

Study: States Like Idaho Paying More For Not Expanding Medicaid

Kaiser Family Foundation
This map shows states where a coverage gap exists for low-income people.

According to a new Kaiser Family Foundation study, the 29 states that expanded Medicaid since the Affordable Care Act have – not surprisingly – witnessed increased enrollment and spending. Those states brought in new low-income enrollees that were not eligible before. In California alone, 3.4 million people were added to the state-run health insurance program.

But despite the uptick in Medicaid enrollment in those states, the cost of the program only went up by 3.4 percent. Compare that to a state like Idaho, where the legislature declined to open the program to low-income residents in 2013. Taken together, non-expansion states saw their Medicaid costs increase by twice as much – up 6.9 percent.

Even after the Affordable Care Act made it easier for Idahoans to get health insurance themselves in the marketplace, 18 percent of the population still falls into a coverage gap. Those people earn too much money to qualify for Medicaid, but not enough to get tax credits to help cover costs from the insurance exchange.

Follow reporter Frankie Barnhill on Twitter @FABarnhill

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