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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.

Reclaim Idaho Taps The Politically Marginalized In Medicaid Expansion Push

Amy Pratt, Idahoans for Healthcare, Medicaid for Idaho, canvas
James Dawson
Boise State Public Radio
48-year-old Amy Pratt personally collected more than 1,000 signatures to help get Proposition 2 on the ballot. It's the first time she's been politically active and she has no plans of stopping.

After years of inaction by the Idaho legislature on the state's healthcare gap, three people traveled throughout the state on a hunch that residents were just as fed up as they were.

That hunch turned into a full-blown campaign to expand Medicaid. It’s also drawn in those who have felt forgotten by the political machine, including Amy Pratt. After 48 years, Pratt decided it was her turn to get involved.

She set out to tell her neighbors in Idaho Falls why she thinks Idaho should expand Medicaid eligibility for up to 91,000 residents.

“I knocked on doors from January 6 until May 1, every door that I could possibly find. I didn’t get paid for it, I have a full-time job,” Pratt says. “I did this for the people that I love, I did this for the people that I care about, I did this for people I don’t even know.”

And that’s where we found her one afternoon, near Idaho Falls High School. She and about a dozen others had gathered in a nearby church basement to canvas nearby neighborhoods.

Not so long ago, Pratt says she wouldn’t have walked so many miles during the biting eastern Idaho winter. But she felt disenfranchised when, in 2002, state lawmakers repealed a popular ballot initiative that imposed term limits on elected officials.

“I felt unheard and uncared for. Maybe term limits was the wrong thing, but for them to overturn it and say that we were wrong was wrong. It was absolutely wrong,” Pratt says.

Luke Mayville, Medicaid for Idaho, Idahoans for Healthcare, Proposition 2
Credit James Dawson / Boise State Public Radio
Boise State Public Radio
Luke Mayville, one of the co-founders of Reclaim Idaho, gives a pep talk to volunteers in Idaho Falls during the final weeks of the campaign to expand Medicaid coverage in Idaho.

So here she is, with a clipboard in one hand and fliers in the other, knocking on more doors than she was assigned – reaching out to grab on to her own little piece of democracy. Pratt was one of the few volunteers who personally gathered more than 1,000 signatures to put Proposition 2 on the ballot.

She was inspired by Luke Mayville, a co-founder of Reclaim Idaho, the group leading this charge. She's not alone.

Several other volunteers who spoke with Boise State Public Radio say this has been the first time they've volunteered for a campaign, whether it's knocking on doors, calling potential voters or staffing a both at the local county fair. Many began paying attention to politics after the 2016 election, helping form liberal groups in traditionally conservative places across Idaho. Though some came from across the political spectrum.

Mayville's moment of inspiration came last Fall.

"The big breakthrough was when the state of Maine came along and proposed a ballot initiative to expand Medicaid. Because we stepped back and thought, whoa, they're gonna win," Mayville says.

And they did. Maine voters passed the measure by a near 20-point margin.

Emily Strizich and her husband Garrett are the other co-founders of Reclaim Idaho. It began as a movement to pass a supplemental school levy in Sandpoint – where Mayville and Garrett Strizich grew up.

But after they won that fight, they started wondering what else they could do.

Emily Strizich, Garrett Strizich, Idahoans for Healthcare, Reclaim Idaho, Proposition 2, Medicaid expansion
Credit James Dawson / Boise State Public Radio
Boise State Public Radio
Garrett and Emily Strizich, right, co-founders of Reclaim Idaho, canvas the recent University of Idaho homecoming tailgate to drum up votes for Proposition 2. They even bring their three-month-old daughter, Simone, with them.

“Garrett came home and was just like, ‘Hey, I think we should paint our camper green and drive it around the state this summer.’ I’ll be honest that I thought they were insane,” Strizich says.

The trio eventually chose to see if there was any appetite in Idaho to expand Medicaid. Emily Strizich wasn’t sure it would work.

“Here I was, not totally sold on the idea, and one of the first doors I knock on is this woman who is deciding between treating these [complications from cancer] that are going to kill her or making her family homeless. And she’s really grappling with this idea: Is my life worth saving?”

But after hearing more and more stories like that, she decided, yes, voters would want to expand Medicaid eligibility to Idaho’s working poor.

This gave her renewed energy. Strizich calls talking to voters her “antidote for hopelessness.”

She worked through the campaign while pregnant and now brings the couple’s three-month-old daughter, Simone, to canvas at events like the University of Idaho homecoming tailgate.

The responses were nearly all positive. The campaign got a similar reaction the next day in more conservative Lewiston, about an hour’s drive south of Moscow.

Jonathan Carkin, Lewiston, Medicaid for Idaho, Reclaim Idaho, Medicaid Expansion
Credit James Dawson / Boise State Public Radio
Boise State Public Radio
Jonathan Carkin, field director for Idahoans for Healthcare, trains a group of about a dozen volunteer door knockers in the Lewiston Orchards in October.

Reclaim Idaho has cast itself as a grassroots, door-to-door movement, though some disagree.  

Fred Birnbaum is the vice president of the Idaho Freedom Foundation. He says outside money – more than half a million dollars – was spent by a progressive group called the Fairness Project, which hired paid signature gatherers.

“I think you can say unequivocally, without the money from the Fairness Project based in D.C., this would not be a ballot initiative in Idaho. They put it over the top,” Birnbaum says.

Staffers at Reclaim Idaho have acknowledged this help was critical. Even though volunteers took in nearly all the signatures needed to get the measure on the ballot, there was a crucial time in March when they needed to reach a specific threshold required by Idaho law.

Still, Jaclyn Kettler, a political science professor at Boise State University, says it’s fair to call this a grassroots effort.

“Canvassing, the door-to-door knocking matters – personal contact really matters for getting a voter to turnout or a citizen to turn out to vote,” Kettler says.

If Proposition 2 passes, lawmakers can add a variety of restrictions to it. They also need to pay for Idaho's share of the program, which is 10 percent of any new costs from those who fall in the expansion population in 2020. Medicaid expansion is held up in Maine, for example, because the governor has refused to fund it.

Regardless of how it turns out at the polls, leaders within Reclaim Idaho intend to continue advocating for issues the state legislature has avoided. Their next campaign might involve universal pre-k education.

Building off of efforts like these can mean the difference between a one-and-done organization and one with staying power.

For Amy Pratt, at least, she sees a clear path ahead, even if Idaho doesn’t expand Medicaid.

“I’m not going to stop. Prop 2 won’t fail, but in the future, I’m going to be active.”

This is the second of a two-part series on Proposition 2. You can find our first story here.

This story has been supported by the Solutions Journalism Network, a nonprofit organization dedicated to rigorous and compelling reporting about responses to social problems.

Follow James Dawson on Twitter @RadioDawson for more local news.

Copyright 2018 Boise State Public Radio

I cover politics and a bit of everything else for Boise State Public Radio. Outside of public meetings, you can find me fly fishing, making cool things out of leather or watching the Seattle Mariners' latest rebuilding season. If you have a tip, please get in touch!

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