Prop 2 (Medicaid expansion): vote no
In this November’s election, we have an important initiative on the ballot: Proposition 2, advocating for Medicaid expansion in Idaho.
What does this Proposition call for? It expands the existing Medicaid program to 100% taxpayer-funded “free” medical care to healthy able-bodied adults up to age 65 whose income is 133% of the federal poverty level or below and who are not eligible for other state insurance coverage. It does not include a work requirement. In Idaho, based on current estimates, it would put between 62,000 to 78,000 individuals on its rolls.
Medicaid expansion was a cornerstone of Obamacare that was struck down by the Supreme Court six years ago as coercive and, in the words of Chief Justice John Roberts, “a gun to the head” of states. “Congress may not simply conscript state agencies in the national bureaucratic army”, he wrote, “and that is what it is attempting to do with the Medicaid expansion” … even though it does not have “the power to transform [Medicaid] so dramatically.” Simultaneously, he admonished states not to cave so quickly to federal demands, writing “The States are separate and independent sovereigns. Sometimes they have to act like it.”
Most red states decided to act like it, Idaho among them. In his 2013 State of the State address Governor Otter said Idaho would not expand Medicaid, and the Legislature has not brought it to the floor.
Medicaid expansion proponents decided to force the issue by collecting the necessary 56,192 signatures to put it on the ballot as Proposition Two. Professional signature gatherers toured the state, distributed colorful, glossy brochures with claims of free healthcare for some additional 62,000 Idahoans who are in the “coverage gap and are unable to acces
s healthcare.” Also, that it would be an economic boon because it would bring nearly $400 million a year of federal money back to Idaho, generate 14,000 jobs, and save the state $68.5 million over the next five years.
The drive for Medicaid expansion called itself “Reclaim Idaho”. An odd name, given that it’s spearheaded by a postdoctoral fellow from Columbia University, New York, who was neither born in the state, does not live or work here, but likes to wear the mantle of “Sandpoint native” because he attended public school here and graduated from Sandpoint High School. Funding for Reclaim Idaho is provided by The Fairness Project out of Washington, D.C., which has paid $500,000-plus to professional signature gatherers, thus hardly an Idaho-originated campaign. The Fairness Project, by the way, is an organization with ties to the scandal-ridden SEIU, and has spent close to $5 million in five states over the past year for similar ballot-initiative campaigns.
How would Medicaid expansion affect Idaho? It is safe to say that it would cause more economic harm than good. Here are some facts:
States that have adopted it have wildly underestimated its costs because, on average, enrollments more than doubled than what was first estimated.
Unsurprisingly, because there is no work requirement, more than half of the 12 million able-bodied adults so far added to Medicaid expansion in the 33 states where it is in place are not working. An indefensible number, given the many jobs available in this economy.
Bloated Medicaid expansion rolls affect states’ budgets by taking funding away from education, infrastructure, and other budget priorities. In Idaho, our Constitution requires a balanced budget. Medicaid expansion will severely dig into that finite amount available. Considering that regular Medicaid costs in Idaho have grown by 100% in the past 12 years while Idaho’s population has grown only 17% signals serious fiscal distress if Medicaid expansion happens.
Even though the federal government will fund 90% of Medicaid expansion costs in 2020, it is noteworthy that this is a drop from its initial 100% funding that has steadily dwindled since 2016, and there is no guarantee for how much the federal government will pay after 2020. Given our $21 trillion federal debt, less funding is likely. Already, states with Medicaid expansion have had to tap into everything from revising work requirements to raising a variety of taxes to cover the ever-expanding Medicaid costs and shrinking federal dollars.
Federal dollars mean federal control. And that is the most serious issue of all here. Idaho would be required to change our laws to conform to federal laws on Medicaid eligibility any time Congress decides to change code sections affecting Medicaid. In other words, Idaho would delegate decision-making power over our Medicaid program to the federal government. Therefore, Proposition Two is a violation of the Idaho Constitution, because only our Legislature can write or change Idaho’s laws. Vote No on Proposition 2.
Victoria Zeischegg
Chairman
Bonner County Republican Central Committee