Guest Opinion

There is a lot of debate surrounding Idaho Proposition 2, the Medicaid Expansion Initiative, and it’s important to look at the issue collectively as a community rather than solely as individuals. Medicaid expansion is a smarter, more effective way to pay for something we are already paying for in many ways. I have made my career in healthcare leadership because I care about the people and communities I know and love. I’m a Lewiston High School and University of Idaho graduate, this great state is my home and I’m voting yes on Proposition 2.

At one point, Medicaid expansion was a partisan issue with a long list of reasons for opposition and the time for approval in Idaho may not have been right; however, Proposition 2 is no longer a partisan bill. The impact it will have on our communities, our friends, our families, and us as individuals is just too great. As citizens, it’s easy to forget we are already paying for the care of those who would benefit most from the approval of Proposition 2. This bill is an opportunity to be smarter about the way we pay for healthcare, while also providing access to preventative care that may contribute to the reduction of overall cost. A vote Yes for Proposition 2 is a vote in favor of yearly premium growth suppression, improves the viability and access to healthcare in our communities, and most importantly a vote Yes provides affordable access to healthcare for our most vulnerable, hardworking population.

Our regional rural hospitals are 503(c)3 organizations, or non-profit, meaning they must reinvest their modest operations margins back into their communities. The highly held public perception that these margins are not modest is simply not true; in fact, rural hospitals are having an ever more difficult time achieving a positive operational margin at all. To put that into perspective, of the 27 critical access hospitals in Idaho only seven had a positive margin last year. Imagine, for a moment, the economic impact of losing 175 jobs in a town of 900 people. It’s a very real scenario impacting critical access hospitals across the country, and at a significantly higher rate in non-Medicaid expansion states. The rural hospitals in our great state of Idaho are feeling the stress about their ability to invest back into their communities.

On a local level, our small businesses largely do not provide healthcare for their employees because they simply cannot afford to do so. These hardworking employees can be classified in two ways: they fall into the Medicaid gap, or they do not fall into the gap, but the premiums in the market are too heavy for them to carry. A vote yes on Proposition 2 will give coverage to hardworking people in the Medicaid gap (and yes, these people are hard workers; they are your neighbors, your friends and your family, not “freeloaders” as the local lingo would suggest). Insuring the gap directly correlates with keeping premiums in the market reasonable, allowing individuals and organizations to access affordable healthcare.  This is a proven effective system as seen in other Medicaid Expansion states.

Proposition 2 is critical to the health and viability of not only our rural hospitals, but more importantly, our local economies. Medicaid expansion benefits the hardworking members of our local small businesses, farms, and forest workers, in both emergency situations and important preventative care. Again, you are paying for this already, in many ways. Let’s do it smarter. Voting yes on Proposition 2 is a vote for the health of this great state, this beautiful region, the communities you are a part of, and the people you love.

Matt Forge, MHA, Chief Administrative Officer, St. Mary’s/Clearwater Valley Hospital and Clinics

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