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The Hyperbole and Horror of Idaho Health Care

"Hyperbole and horror stories. While they're useful to a point, I think we've heard those."

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At the same time Gov. C.L. "Butch" Otter, Senate President Pro-Tem Brent Hill (R-Rexburg) and House Speaker Scott Bedke (R-Oakley) were congratulating each other for what they called "a successful session"—in spite of not addressing the Medicaid coverage gap—officials with the U.S. Department of Health and Human Services unveiled yet another study pointing to the ill effects of not expanding the program.

"I have to say, I think we had a pretty good legislative session," Otter said March 28, adding he had no intention of calling for a special session of the Legislature to deal with the nearly 78,000 Idahoans ineligible for health care assistance.

"You have a firm commitment from the House of Representatives that we want to do something on this issue," said Bedke.

Only 72 hours before, Bedke gaveled the 2016 session of the Idaho Legislature closed, Sine Die ("without a day"), after Republican majority leadership led a tidal wave of dissent against any proposal to consider the tens of thousands of Idahoans who either make too little to participate in the state-run health care exchange or too much to be eligible for Medicaid.

The House adjournment came one day after a stunning remark on the floor of the Idaho Senate from Sen. Jim Rice (R-Caldwell).

"Not one of those who left bloody tracks in the snow at Valley Forge did so over free health care. It's not a right," Rice said.

Instead of referencing Rice's hyperbole, Bedke chose to chastise Dr. Kenneth Krell, director of critical care at Eastern Idaho Regional Medical Cente. Bedke testified Feb. 2 that as many as 1,000 Idahoans have died prematurely over the past three years because the state hasn't expanded Medicaid.

"Hyperbole and horror stories. While they're useful to a point, I think that we've heard those," Bedke said March 28.

It's a fair bet Bedke hadn't heard of the latest data from HHS. The new study shows an increasing number of people who could benefit from Medicaid expansion also have behavioral health needs. The study indicates as many as 39 percent of uninsured Idahoans ineligible for Medicaid assistance reported mental illness or substance use disorder. That percentage, according to the study, represents as many as 30,000 uninsured Idahoans.

"The facts are clear. The consequences of a state's decision to reject Medicaid expansion are far-reaching," said Vikki Wachino, director for the Center for Medicaid and CHIP (Children's Health Insurance Plan) Services, part of the Centers for Medicare and Medicaid Services.

Dr. Richard Frank, a Harvard Medical School professor and HHS assistant secretary for Planning and Evaluation, said by accessing federal funds to expand Medicaid, states such as Idaho can drill down into what he called "more vexing issues."

"This would open up new opportunities to meet other pressing mental health and health care needs," Frank told Boise Weekly. "And states such as yours could also better address vexing problems such as homelessness through Medicaid expansion."

Meanwhile, at the Idaho Statehouse, Otter bristled at outside criticism.

"Those who suggest that the Republicans in the Legislature don't care about the 78,000 are dead wrong. We care," said Otter. "We're just trying to get a solution and trying not to make false promises."

As for the future, Hill and Bedke said they were looking forward to "working with the governor's office to craft a state-based solution" over the next several months.

"But the House feels strongly that there has to be a legislative component to that solution," said Bedke.

Hill echoed Bedke's remarks, adding, "We didn't get everything done. We'll have some things for next year."