John Livingston


There seems to be little appetite amongst the rank and file in either the Idaho House of Representatives or The Idaho Senate to address the real “Elephant in The Room” that will eventually—sooner rather than later I believe, come to have a real negative impact on Idaho families, businesses, farmers, and ranchers. CORRUPTION in government and corruption in the way that Idaho government interacts with the private sector is more than problematic. It is METASTATIC. It is ubiquitous. Members of leadership have expressed concerns to me for now over two years, but they are having trouble rallying the troops who are having trouble “connecting the dots” for their constituents who don’t see today the connection between their increased health insurance premiums, and the Medicaid subsidies being paid out to providers—profits and non-profits, and a fraudulent Medicaid system where one in seven Idahoans are on Medicaid and one in three Medicaid recipients in Idaho don’t meet enrollment criteria.

When the system is gamed by providers and their fellow citizens, honest working families and businesses suffer. And let’s not forget the non-profit hospital systems—before Medicaid Expansion there was never a CEO of such an organization who made anywhere near $18million/2yrs. Without audits of the DHW or of organizations that receive over $100million of transfer payments/ year such legalized corruption will continue, and WE THE PEOPLE will continue paying for it. And if the time ever comes when the Republicans will control Congress in Washington DC and the Medicaid match formula changes, other areas of our state budget will be adversely affected—like education and infrastructure development and maintenance.

I can only speak to programs that I have worked with in the past 10 years. When I was privileged to serve on the Idaho Health Insurance Exchange Board there were two issues I was concerned about. Eligibility criteria of participants, a significant number who I thought were gaming the system to the detriment of the entire program, and the ability to “privatize” the exchange that may facilitate proper documentation and implementation of enrollment criteria because the exchange would be in the hands of the brokers—who would have even more economic “skin’ in the game than they do today. We have no idea of the number of enrollees in exchange products who may be gaming the system. I know of one legislator who owns a very successful family business, who encouraged his own college age children to shop for health insurance on the exchange. One of those children worked “part time” in the family business while also attending college.

I testified 10 years ago prior to Medicaid Expansion that when aggregate supply shrinks—the number of providers decreases as in hospital beds and the shrinking of the supply in the market by “vertical integration”(large hospital systems buying medical practices thus limiting options for patients (consumers) in the market place), and at the same time increasing demand; prices will always go up—as they have for the past 7 years at the tune of 7% per annum at least some of which goes to pay CEO’s who make $18million/ year serving their community non-profits. AUDITS PLEASE!

Let’s never forget the mantra of the Expansionists: Access—quality—cost. How was access during Covid? Has the quality of medical care improved over the past 10 years? Cost—who could have anticipated such an explosion in health care costs with government subsidies going to both sides—supply (providers) and demand (Medicaid recipients)?

Better watch out Idaho. When the Medicaid match shifts, the costs to families, individuals, and businesses, that everyday hard-working people will pay in increased health care insurance premiums and taxes will skyrocket. The time to address corruption in Idaho is now

As they say in the Nuclear Navy: BOHICA— Bend over here it comes again! That’s the way I see things from where I sit in Garden City.

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