Equitable assessment

This week in Boise there will be an interim committee meeting on Monday. By the time you read this they will be back home, not done with their work, but maybe started. The title of the committee is the “Equitable Assessment of Costs Related to Medicaid Expansion”. I applaud the legislature for looking carefully at costs incurred to the taxpayer for the laws they (or in this case, the voters through initiative) pass. May I make some further suggestions?

How about the legislature study the costs of funding facilities for charter schools? The legislature passed a law in 2014 to send cash from income and sales tax revenue to charter schools for their facility costs. Public schools have to get a local bond passed to build a school; charter schools get an automatic cut from everybody’s sales taxes or income taxes. Sixty-six + percent must approve a local bond, then it comes off the property tax of local district residents. Charter schools just get a check out of the general fund. That charter school facility fund has come to $40M over the past seven years. And its dollars straight out of the budget for teachers and schools, which is what our property tax levies pay make up for, since the state can’t seem to find the money in the general fund. Seem equitable to you?  

How about the legislature study the property tax exemptions county commissioners are handing out? How is that affecting home owners’ rates? Canyon County commissioners just handed out millions in exemptions to businesses who expanded or opened new facilities. A couple years back Nez Perce County commissioners did the same for Clearwater Paper. This was right before they laid off a few dozen workers in the Lewiston plant. Does it seem equitable that businesses don’t have to pay for the roads and services their trucks and employees use? Does it seem equitable that the local property owners foot that bill?

But I suspect the interim committee will focus their “equitable assessment” on the costs of Medicaid expansion, as the law they themselves passed has directed them to do. If you keep the window narrow there is no big picture to see. I expect my elected representatives to see the big picture.

The charter school facility funding inequity came about because the legislature was afraid to look at the big picture of all schools’ facility funding. This was even though there is an Idaho Supreme Court decision declaring our current system, before the charter school facility funding scheme, unconstitutional. This decision has never merited even one hearing from our busy legislators.

Keeping a narrow focus on the Medicaid costs might bring some comfort to the legislators who opposed Medicaid expansion. While they tally the costs, will they even try to balance the benefits? We all heard their bias before the election, before the citizens over-ruled their six years of inaction. Will they consider the costs of those six years of doing nothing when the Federal Government paid up to 100% of the costs? I doubt it.

There is no doubt the expansion of Medicaid will cost the Idaho taxpayer. And costs are the easiest things to count. But the benefits deserve some tallying too. What do you think one life saved is worth? Can they tally savings to our prison costs when a felon doesn’t return to prison because they got their drug addiction treated? Can they consider the value to a small community whose critical access hospital climbs out of the red? Is there any way to count the shifted costs of the uninsured onto those paying premiums? Will the decline in county property tax funded indigent costs be part of their calculus?

I’m all for counting costs. But how we spend our money is an expression of our values. And values aren’t just about dollars and cents. Values should reflect the big picture.

About ddxdx

A Family physician, former county coroner and former Idaho State Senator
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