Medicaid: Enlarge, reduce or keep as is? Recipients, doctors, lawyers and legislators evaluate an expansion

CREATED Jul. 20, 2012

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  • Without Medicaid, Boise’s Ron Whitmore and Roy Nelson said they wouldn’t live long. Video by IdahoOnYourSide.com

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Without Medicaid, Boise’s Ron Whitmore and Roy Nelson said they wouldn’t live long.

“I would be doing without,” Whitmore said. “I’d probably just end up dying in some corner of the park.”

Whitmore suffers from a hernia in his esophagus. Medicaid scheduled him for surgery in the coming weeks. Nelson has a rare degenerative back disease. The government paid for his surgery last month.

Neither man believed Medicaid accomplished as much as it could or should.

“It doesn’t have to be a jump-through-a-hoop type of situation,” Nelson said.

But both grew animated imagining how they’d live without coverage.

“One prescription alone is $1,200 dollars,” Whitmore said. “Without Medicaid, I wouldn’t be taking any meds.”

Safety-net clinic doctor Dr. Ted Epperly sees patients without Medicaid every day.

“They live sicker,” he said, “die younger.”

For that reason, Epperly said, he supported Obamacare’s forced expansion of the program. The Supreme Court did not: It upheld the Affordable Care Act but ruled that coercing a state to enlarge Medicaid or suffer the loss of federal dollars went too far.

The state of Maine interpreted that ruling to mean it could strip coverage from those currently on Medicaid.

“It would appear under the Obamacare ruling by the U.S. Supreme Court, that Maine and every other state can make those kinds of adjustments,” former Idaho Attorney General David Leroy said.

“I see that as being a step backwards, quite frankly,” Epperly said.

Gov. Otter appointed Epperly and 13 others to a special panel tasked with weighing whether or not to expand Medicaid in Idaho.

“In terms of Medicaid and what we do with Medicaid,” Rep. Fred Wood said, “it’s very simply a financial calculation.”

Wood said he hadn't yet decided whether or not Idaho should expand its program and he needed to wait to hear from his colleagues on the panel first.

Wood did admit his opinion on the subject would depend on the answer to one question: Will this save Idaho money? Today? Tomorrow? In 10 years?

The federal government promised to pay for 100 percent of the expansion for the next two years and then 90 percent after that.

“So, if we don’t step forward and do this for the good of Idahoans,” Epperly said, “we’re going to be paying taxes anyway that’ll expand Medicaid in Washington, Oregon, Montana, Utah and other places.”

Greater coverage might also mean help for more guys like Whitmore and Nelson.

“Sometimes in life, no matter who you are – I don’t care if you wear a hardhat or a tie – you’re going to come to some grips and need a little help,” Nelson said.

Idaho must now decide how much that help could cost.

Otter’s panel plans to meet the first week of August.