The Idaho Freedom Foundation’s Wayne Hoffman has an interesting solution for providing health care coverage to the working poor – and Medicare expansion is not it.

“Voluntary giving is the way to help solve the Medicaid gap,” Hoffman says. “When people give of their own volition, they’re more invested in the outcome.”

He says proponents of Medicaid expansion, aiming to put a voter initiative on the ballot, have not helped the poor. “They’ve not taken up a collection. They’ve not helped pay for a poor person’s medical care or insurance coverage. They merely gripe about legislative inaction.”

Creating a charity to help some 78,000 of the working poor who cannot get health insurance isn’t a bad thought … if Medicaid never existed. But the program has been in place since 1965, and states have had options to expand Medicaid before anybody heard about Obamacare. It’s unrealistic to establish a charity to supplement a government program that already is being underwritten by taxpayers.

The question is not whether Medicaid should exist, but what to do about the working poor that can’t get health coverage. Medicaid expansion may not be the answer, but nobody with any authority has come up with a better idea in the last six years. Earlier this year, Gov. Butch Otter and Lt. Gov. Brad Little tried to push through legislation that would offer cheaper insurance plans to the working poor, but that went to the same graveyard as other “Idaho solutions” over the years.

The voter initiative effort, spearheaded by Sandpoint native Luke Mayville, is a result of the frustration Idahoans feel about nothing getting done. Betsy Russell of the Idaho Press in Nampa explained it well in a recent commentary.

“If Idaho expands Medicaid, the federal government would cover 90 percent of the cost, tapping federal tax funds that Idahoans already pay,” she wrote. “And current state programs to cover catastrophic medical bills for Idahoans who can’t pay wouldn’t need the millions in state and local taxes they now consume.”

As Mayville told Russell, “Medicaid expansion would immediately start saving taxpayer money, and then in the medium term it would generate all kinds of economic benefits by bringing so many of our federal dollars back into Idaho.”

Rep. Christy Perry of Nampa, who soon will be leaving the Legislature after losing her bid for Congress, is one Republican who backs Mayfield’s efforts.

“There has been a frustration on their part. They don’t feel the Legislature has proven it could get anywhere on this issue,” she said. “I feel in the political arena now, people are feeling empowered and are stepping up to be more involved with government. I’m excited about this.”

Perry thinks Otter and Little were on track with their plan earlier this year, and criticized the Legislature for its six years of inaction on the gap issue.

“It was a different idea that was presented to the Legislature, yet there was no willingness to even have the conversation,” she said. “When we left, there was nothing to say that we really made the effort. We just flat-out didn’t even have the conversation. Medical care is getting paid for anyway, one way or the other,” she said.

As a legislator, and congressional candidate, “I’ve seen people crying their hearts out, and have heard stories about people dying because they couldn’t get medical care,” Perry said. “We should not be treating our citizens like this.”

Obamacare is a nasty word in Republican circles, and a big reason why there is resistance to Medicare expansion. But in Perry’s view, the policy should not be a barrier to fulfilling the people’s needs.

“I want to see the people taken care of, whether I’m a legislator or a private citizen, she said. “Then, if there are issues with the policy, you can work on that later. But the priority should be with the people, and I think Idaho citizens are going to get their say.”

The citizens could make life a bit rough for a new governor, especially if it’s Little, who has expressed opposition to Medicaid expansion. But he wouldn’t be in this jam if the Legislature had done the right things in the first place.

Chuck Malloy, a long-time Idaho journalist, is a columnist with Idaho Politics Weekly. He may be reached at This email address is being protected from spambots. You need JavaScript enabled to view it.