Merry Christmas Idaho

Ever get a present that made you really happy? Ever get one that disappointed? Well, the Idaho legislature got a present from the voters November 6th they didn’t really like: Proposition 2, Medicaid expansion. This citizen initiative passed in 29 of 35 legislative districts; in many of those districts legislators actively opposed it. So, the legislature got a gift. I hope they don’t throw a fit like my daughter did when we got her the knock-off athletic bag instead of the name brand. We still tease her about it.

There are many times when we look for excuses to not do the right thing instead of throwing a tantrum. It usually involves whining. The Idaho Freedom Foundation is giving legislators an excuse through their lawsuit about the constitutionality of Prop 2. I’m glad the Idaho Supreme Court has allowed folks with stronger standing to add their voices to the argument. And the whole question of whether the Affordable Care Act is constitutional, brought up by Republicans before a partisan Texas judge will get to play out. It’s just another excuse for those who want to whine.

But the excuse I hear from what I consider otherwise level-headed legislators is the handwringing, maybe with a little whining involved: “We just can’t afford it.” This excuse is just poppycock.

Every credible analysis of the funding requirements for Medicaid expansion have shown that in the long run, this policy choice either saves Idaho money, or costs very little. The ones that have shown minor costs have not included savings from keeping folks out of prison, expanding Idaho’s economy or keeping rural hospitals afloat. Anybody who has looked at the analysis understands this, even Republicans.

But there will be initial costs for Idaho, since the savings from reducing the CAT Fund and county indigent costs will take a few years to show up. Kind of like when you buy those expensive LED lights, they cost a bit up front, but the lower electric bills actually pay for them in a few years. But that initial cost can be an excuse for you to not conserve, not do the right thing. Please don’t whine as you pass the light bulb isle in Walmart.

This legislative whining about not being able to afford it comes from your representatives that don’t really know the numbers of Idaho’s budget. I will admit, it’s complicated, but after I served on the budget committee a couple years, I got some understanding. All legislators should serve on this committee. Many don’t; it’s hard work.

There is a ready source for over half the initial cost of Medicaid expansion from Millennium Fund money. This is money Idaho gets from the tobacco settlement, about $20M a year. We have passed a Constitutional amendment that this money must be used to build an endowment fund, so it can’t be used directly. The Millennium endowment fund now sits at $300M. That makes over $18M a year available.

Next you have to consider what we have been doing with your tax revenues for the last 10 years. Idaho has replenished our reserve funds to the tune of over $65M a year. One of the reserve funds is now at its maximum amount allowed by law. Even with last year’s tax cut and Idaho’s revenues coming in under projections the last six months, Idaho has plenty of revenue to fund Medicaid expansion. Once we get the train moving out of the station, repeal the CAT Fund, the momentum will take care of itself.

From Idaho Fiscal Facts 2018



Brad Little knows this; he served on the budget committee. Most legislative leaders know this. Don’t listen when they whine about the present they just got.


About ddxdx

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