Idaho lawmakers are searching for ways to pay for the state’s impending Medicaid expansion bill and counties may help shoulder some of it.
Right now, each of Idaho’s 44 counties pays for a portion of a person’s medical bills if they’re found to be indigent, with the state picking up the rest.
Earlier this year, Rep. Fred Wood (R-Burley) introduced a bill that would’ve charged counties money based on how many residents enrolled under the state’s voter-approved Medicaid expansion.
An estimated 91,000 people will be eligible when enrollment opens Nov. 1. Coverage will begin Jan. 1, 2020.
Wood’s bill went nowhere, but he now co-chairs a committee charged with drawing up recommendations on how to cover an estimated $105 million in expansion costs over the next 10 years.
“We’re spending more money than it actually takes right now,” he says, referring to the difference in Medicaid costs versus the current system.
But counties aren’t gung-ho on the idea.
“If you expect counties to pay for Medicaid expansion and at the same time expect them to maintain the indigent program for those that don’t qualify for Medicaid, it’s actually going to be more expensive for the counties than what we’re seeing right now,” says Seth Grigg, the executive director of the Association of Idaho Counties.
It could be more expensive because at least 18% of indigent cases wouldn’t qualify for the expansion. That total could be more, depending on whether the federal government approves a waiver that would require those getting health insurance under the expansion to work.
Another option on the table includes grabbing cash from the anti-smoking Millennium Fund. Lawmakers set aside a little more than $10 million earlier this year to help pay for six months of coverage when the program starts in January.
The committee will meet three more times to make recommendations before the legislature reconvenes next year.
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