Currently, at least 70,000 Idahoans fall into a gap where they don't meet the state's Medicaid eligibility requirements while also failing to qualify for a tax credit under the state health insurance exchange. Most of these are adults without children, single-parent families who fall just shy of the federal poverty line.
Idaho's GOP-dominated Legislature has remained hesitant to address Medicaid expansion, a provision provided under the federal health care overhaul, ever since the U.S. Supreme Court ruled that states can have the final say on whether to expand.
The situation became even more politically heated after Idaho lawmakers who voted in favor of the state-based health insurance exchange became targets of far-right challengers and tea party groups. The political backlash of supporting the Affordable Care Act left many refusing to even consider expanding Medicaid despite hearing support from state medical, hospital and insurance groups.
Yet Dr. Ted Epperly of Boise says Idaho's current indigent system is not sustainable and lawmakers must stop avoiding the difficult topic.
"We need to get off our butts and do something," Epperly said.
Moyle countered that it will be up to stakeholders to launch an education campaign to begin selling an idea many consider politically toxic. He added that he would support putting the Medicaid expansion options as a voter-initiative.
GOP Rep. Tom Loertscher of Iona, who also voted against the recommendation, said that he still needed more information about long-term trends of Medicaid expansion before he could support the idea and try to convince others to also vote in favor of it.
As the original sponsor of the state's current indigent fund —a program that has since been described by many as broken — Loertscher said he's been rejected by GOP lawmakers anytime he tries to suggest Medicaid expansion.
"When I confronted my colleagues, they could agree that this could save the state millions, but they won't vote for it," he said. "We need more education, but I don't know if that will work in this political climate."