BOISE -- A panel of state and community leaders recommended Friday that Gov. Butch Otter and the Idaho legislature expand Medicaid to cover more than 100,000 additional low-income residents.

The 15-person panel has been meeting for several months to analyze costs and benefits of expanding Medicaid eligibility.

It's a key provision of President Barack Obama's health insurance overhaul, but one that the U.S. Supreme Court left up to states to decide.

Dick Armstrong, the director of the Idaho Department of Health and Welfare, says this is a unique expansion in that it is truly economically driven and not tied to an underlying disability or age.

This is addressing the working poor, said Armstrong. These are the adults who are working at jobs and don't make enough money to buy health insurance. Their employers don't provide it and they are dealing with the affects of health care costs.

Armstrong says those affected use the system in a time of crisis -- when care for them is the highest.

The expansion would cut costs on the county and state level -- and shift it to the federal level.

Those presenting to the group say this not only makes sense, but will save the state money.

It can't be done by just one side, by the way, said Armstrong. What we're hearing today is both the patient and the health care delivery system have to have common incentives to move closer together for a better outcome.

And that means a change to the payment system.

It does begin to address putting the patient or the client into the game a little bit more, said Armstrong. And if they do certain things to improve their health, then they get some incentives.

A Seattle-based actuarial firm told the group before Friday's vote that Idaho will save $6.5 million through 2024 by expanding Medicaid eligibility -- and suffer costs of $284 million by rejecting it.

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