Close the Gap Idaho Statement Urging
Congress to Oppose the AHCA

Close the Gap Idaho is a coalition of consumer, provider, and advocacy groups that are deeply vested in Idaho’s health care system. We are writing now to share concerns about the health bill currently under consideration in Congress, the American Health Care Act (AHCA). The AHCA will do grave damage to Idaho’s most vulnerable residents, will have a negative impact on our state budget, and our public health funding will be dramatically reduced. Over time, the number of people without insurance will rise, leading to an increase in medical bankruptcy, less access to critical health services, and negative health outcomes for Idahoans.

We recognize the Affordable Care Act is not perfect, and we are working to move Idaho and the country’s health care systems forward. We believe the AHCA will not achieve positive outcomes. Instead, it will be a detriment to Idaho.

AHCA would lead to an enormous increase in the number of uninsured Idahoans. The Congressional Budget Office (CBO) estimate, released on March 13, indicates 14 million Americans could lose insurance next year under the AHCA and by 2026 that number will grow to 24 million. Specific state data is still being calculated and has not been released, but early estimates indicate that over 90,000 Idahoans could lose health insurance coverage over the next ten years. The director of Idaho’s state health insurance exchange indicated last week that as many as 60,000 Idaho customers will be lost from the exchange if the bill as currently written is enacted.

AHCA would put public health funding at risk. Since the fund’s inception in fiscal year 2010, The Prevention and Public Health Fund (PPHF) is integral to Centers for Disease and Control and Prevention (CDC) programs and state and local health programs. Several core public health programs in Idaho are now supported by PPHF. In most cases the PPHF has either replaced or supplemented previous funding. Core public health programs rely on the PPHF, including programs focused on diabetes prevention, heart disease and stroke prevention, fall prevention for seniors, sexual violence prevention, tobacco prevention and cessation, immunizations, epidemiology and laboratory capacity, adolescent pregnancy prevention, and health risk behavior surveillance. The AHCA would eliminate funding for these programs.

AHCA would lead to cost-shifts to Idaho as a result of Medicaid per capita caps. Eligibility guidelines for Idaho’s Medicaid program are some of the strictest in the country, and our Medicaid is incredibly cost-effective and efficient. For every $1 invested in Idaho’s Medicaid program, 97 cents is spent directly on health services for Medicaid participants, with just 3 cents going to administrative costs. The CBO estimates the AHCA would cut $880 billion in federal Medicaid funding over ten years. As federal support diminishes and health care costs shift to states, Idaho will have to either fund care for seniors, children, and people with disabilities or cut services to the most vulnerable. Because federal Medicaid funding makes up such a significant part of Idaho’s state budget, large cost shifts will mean that our state budget and municipal bond ratings will be adversely affected. Other state budget obligations, such as K-12 education, will be strained and could potentially face cuts as well.

The AHCA puts Idaho’s most vulnerable residents and children at risk. Seventy three percent of all Medicaid and CHIP enrollees in Idaho are children. One-third of children with cancer in Idaho are on Medicaid. The majority of Idaho’s Medicaid spending is for high-cost, vulnerable populations, including Idahoans with disabilities and elderly Idahoans qualifying for nursing home care. Medicaid block grants and per capita caps, as proposed and described in the AHCA, would likely result in cuts to coverage benefits for many of these Idahoans.

These concerns make it impossible for Close the Gap Idaho to support passage of the AHCA at this time. We urge you to carefully consider the impacts of this current proposal on Idaho and oppose the effort to pass the AHCA in such a hurried manner. The implications to Idaho’s economy and the health of our communities depend on your careful and considerate deliberation. We look forward to being a helpful partner and resource to you as you make these critical decisions on our behalf.