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GUEST OPINION
Following all the news can be difficult.
Important things easily get lost in the shuffle and health care headlines can be especially tough to understand. News reported over the past couple of months in the Idaho Capital Sun offers important insight into Idahoans’ need for health care as the 2026 session looms in Boise. These stories highlighted issues with our state’s approach to applying bureaucratic red tape to Medicaid implementation and offer something of a warning of potential significant problems soon to come.
A recent report by the Idaho Department of Health and Welfares showed that major companies and government agencies have many employees who rely on Medicaid expansion for access to health care. The department found that, as less than half of state employers offer benefits as part of compensation, many of the folks who access Medicaid expansion work at major corporations like Amazon and Wal-Mart as well as at the state’s largest universities, like the private Brigham Young University-Idaho in Rexburg and state schools Boise State University and the University of Idaho. BYU-Idaho employees are one of the largest groups accessing insurance coverage through Medicaid expansion, according to the report by the Idaho Department of Health and Welfare.
Another report, this one from the non-partisan Georgetown University Center for Children and Families, found that the number of uninsured children in Idaho increased at the nation’s second-highest rate during the post-pandemic period, when eligibility checks for Medicaid re-started. The number increased from an estimated 28,000 to 40,000. Many of those newly uninsured children were still fully eligible, but lost care through bureaucratic red tape as Idaho tore through the unwinding at one of the nation’s fastest rates, ignoring clearly voiced concerns that the process seemed to value quick purging of the rolls over keeping eligible people covered, just as we are seeing now with the newly adopted monthly work reporting mandates.
The resulting increase in the uninsured population means more families are now one unplanned medical episode away from significant debt or the need to decide between paying for needed care or a month’s worth of groceries.
The combined message from both stories — and many others of late — must be clearly heard by the state’s leadership: Idaho families rely on Medicaid expansion to stay healthy and working. That also means Idaho’s business infrastructure relies on Medicaid expansion to support the people needed for a healthy workforce.
The more barriers the state places on Medicaid expansion, or even entertains the idea of eliminating it altogether, the greater the risk to Idaho’s health and economy. There is no backup plan, no safety net waiting to catch those who lose coverage. That’s why it is imperative for the state to proceed more carefully than ever to avoid inflicting additional harm on people who already face significant financial obstacles in the form of mounting inflation. Currently, Medicaid expansion remains one of the most effective and fiscally responsible tools available to keep Idaho families healthy, employed and contributing to a stronger state economy.
They do not need the additional paperwork of monthly work reporting, which is why the state should apply for a good faith waiver to the federal work requirements mandate. The additional year the waiver could grant would give state staffers time to put the plan in place and save Idahoans from at least one year of overwhelming reporting mandates while they are doing all they can to support themselves and their children.
Medicaid expansion currently covers more than 88,000 Idahoans and is critical in rural areas and for our friends and family with serious conditions, like cancer or diabetes. As we learned in the state study, these are our local restaurant and retail workers, public school and university staff and many of our neighbors. These are young parents and professionals trying to get ahead or at least not slip backwards and there are also 20 percent of users living with significant mental illness who are able to get the treatment they need.
Removing folks from the Medicaid rolls does not save money. It pushes the costs on to providers and leads to increased premiums for everybody. Those without health coverage will be forced to seek out already stressed emergency rooms when their health is at a crisis point.
It is important to note that Medicaid expansion does not provide a check, only access to care. It is a health insurance program, not a source of income. It covers one of every 10 Idahoans diagnosed with cancer, of which our state will see 12,000 new cases this year, a number that won’t decrease by taking care from people who already face increased barriers to accessing recommended screenings and doctor’s visits.
This is why so many health-focused organizations have opposed cuts to Medicaid in all forms: The evidence and facts show that they simply are bad for people’s health.
RANDY JOHNSON IS A MILITARY VETERAN AND THE IDAHO GOVERNMENT RELATIONS DIRECTOR FOR THE AMERICAN CANCER SOCIETY CANCER ACTION NETWORK.
