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BOISE -- For a second year, Gov. C.L. Butch Otter threw cold water on hopes of expanding eligibility in Idaho for the Medicaid health insurance program during the coming year.

President Barack Obama's health care overhaul envisioned adding many low-income singles, among others, to the program, but the U.S. Supreme Court left the decision up to states.

Instead of taking additional federal money to cover the health insurance program for the poor, elderly and disabled, Otter said in his State of the State speech Monday he wants to make changes to the system first.

That includes focusing on prevention and outcomes, rather than the existing system that he says concentrates too much on payments for services.

Otter says he's also following what other states are doing to overhaul their Medicaid systems.

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