OPINION: What Idahoans want, they’re not going to get

For the first time in several years, more Idahoans believe their state is on the right track.

According to the Boise State University public policy survey of 1,000 Idaho residents, 49% say the state is headed in the right direction; 37% disagree.

But you have to wonder how long that assessment might hold up when the 2025 Idaho Legislature gets done with them.

Exhibit A — health care.

According to the BSU survey, 49.2% of Idahoans say it’s difficult to get health care. That number is even higher — 56% — for women. And the survey says low-income families are 13 percentage points more likely to have trouble obtaining health care.

Yet the Idaho Legislature is about to make that worse.

Against the wishes of the GOP-led Legislature, Idaho voters in 2018 voted by nearly 61% to expand Medicaid coverage to the working poor — people who could not afford subsidized private health insurance under Obamacare but did not qualify for traditional Medicaid.

Repealing or reversing Medicaid expansion is an obvious threat to the 81,500 people who rely on it.

But it’s no picnic for everyone else.

Under Medicaid expansion, the federal government picks up 90% of the tab. In all, the program added about $713 million to Idaho’s economy as of two years ago.

Even so, about half of Idaho’s hospitals are barely scraping by — even losing money. In 2022, the last year available, they absorbed $78 million in charity care and $203 million in bad debt.

Take Medicaid expansion’s dollars out of the equation and you’re likely to see continued diminution in the quantity of services those hospitals provide.

What’s more, the cost of health care for those who can still afford it will climb.

Exhibit B — abortion.

After the Donald Trump-appointed U.S. Supreme Court reversed 50 years of reproductive autonomy, Idaho lawmakers became the dog that caught the car. Their abortion ban is among the most severe in the country.

It’s not popular. Add up the options and there is a 55.4% majority that supports elective abortions through the first trimester.

That’s unlikely to happen unless and until Idaho voters change the law through the initiative process.

But nobody saw how the threat of imprisonment for health care providers who violate the ban would compromise the health of women who welcomed their pregnancies, only to have something go horribly wrong. They’ve been forced to endure prolonged miscarriages, carry fetuses that will not survive and risk permanent injury and/or the loss of fertility unless they can travel to another state for help.

It’s also spawned an exodus of physicians, who refuse to compromise patient care in order to continue practicing medicine. One of five Idaho obstetricians — and more than half of its full-time maternal-fetal medicine specialists — left the state. The vacancy rate among OB-GYNs has expanded by two or three times. And maternal health care deserts are spreading across the Gem State.

No wonder a consensus is building for a health exemption. Not a broad one, but a measure that would allow physicians to act on a good faith judgment to address a pregnancy that complicates a woman’s medical condition in order to avoid serious risk of “substantial impairment of a major bodily function or serious dysfunction of any bodily organ.”

According to the BSU survey, such a plan would enjoy the support of 64.1% of Idahoans.

So as the state enters the third year of its abortion ban, where is the health exception?

Gov. Brad Little says it’s too soon, given the state’s lawsuit over a federal requirement that hospital emergency rooms to stabilize women undergoing crisis pregnancies.

No proposed bill has emerged, even though two leading lawmakers — House State Affairs Committee Chairperson Brent Crane, R-Nampa, and House Health and Welfare Committee Chairperson John Vander Woude, R-Nampa — promised to act more than a year ago.

Exhibit C — vouchers.

You’d be hard-pressed to find anything in the BSU survey that justifies the current legislative frenzy toward siphoning public education funding and handing it over to private and religious schools.

Asked where they’d spend their money, 47.5% backed higher public school teacher salaries. An additional 19.8% said tax dollars should go toward improving school buildings and facilities. Only 14.9% like the idea of “allowing tax dollars to be used to pay for private or religious education.”

Put another way, 53.3% opposed spending tax dollars on private schools.

Perhaps it’s beginning to get through that Idaho’s underfunded schools across the state would suffer in order to subsidize the parents of children who already attend private classrooms in a handful of urban centers.

Or maybe Idahoans are latching on to the reality that it never ends with a pilot program. Eventually, lawmakers will yield to pressure to make vouchers an entitlement available to all — which could put a $360 million hole in Idaho’s budget.

But out-of-state special interests defeated voucher skeptics and even Gov. Little — who resisted the idea in the past — has signed on to a $50 million program, with restraints.

So why won’t Idahoans get what they want from their elected state leaders? Why are they forced to accept what they don’t?

Take a hard look at the people you’re sending to Boise. And if you don’t vote, don’t gripe. — M.T.