Of course the Idaho Legislature faces some tough decisions. The projected revenue (whether accurate or not) is far short of the cost of running the state government for 2012. Medicaid is a very large part of the cost and so it is a natural target for cuts. But, like any enterprise, you can’t always balance the budget by cutting the largest cost centers. A retailer can’t recover by closing its most profitable stores. A family can’t make ends meet by eliminating food from the budget, or selling the car that takes them to work. Medicaid is the largest single source of federal revenue to the state of Idaho. It is our best opportunity for bringing back into the Idaho economy the hard earned tax dollars Idahoans have sent to Washington D.C. For every three dollars of State funds spent on Medicaid we bring back to Idaho seven dollars of federal funds. If we cut 3 dollars, we leave the 7 dollars in Washington.
Where do Medicaid dollars go? Medicaid is extremely labor intensive. Almost all of the money funds jobs for hard working Idahoans. When they get paid they buy food, shelter, clothing, and other Idaho products, and they pay taxes. Then the businesses they support pay wages for other people’s jobs and they also pay taxes. So what is the effect of cutting $50,000,000 in state funds from Medicaid? We suck $166,000,000 out of Idaho’s economy. We kill about $208,000,000 in total economic activity. We eliminate about 4,000 Idaho jobs. Based on economic studies in other states we lose about $30 to $50 million in tax revenues wiping out the “savings”. We cause untold suffering and some deaths. We force people into poverty and unemployment. We shift Medicaid recipients into state funded programs like county indigent services and the catastrophic health care fund. We shift people with severe mental illness into Hospitals, courts systems, jails creating a huge burden on local taxpayers. Even if only 10 percent of the cost is shifted, the added state tax burden is estimated to be about $16.7 million in the first year and more after that. There is every reason to believe that the shift would be far higher than that. This does not even count the cost shifts that will take place within Medicaid from lower cost optional services to higher cost mandatory services. This does not count the costs of increased psychiatric hospitalization, emergency room visits.
Does anyone still think we can solve our budget problem by cutting Medicaid?
Like any business or family in economic trouble, we need to cut out waste, but preserve and increase our ability to bring in income. You cannot balance the budget by destroying jobs, eliminating essential public health services and shifting costs to local government while leaving $116,000,000 of our federal tax dollars in Washington D.C.
A little effort on the revenue side, whether it is tobacco, alcohol, or sales taxes will prevent a lot of suffering, save lives, and might actually balance the budget. Cutting $50,000,000 out of Medicaid will do just the opposite.