POCATELLO — With the Nov. 8 election day fast approaching, local legislative candidates recently exchanged viewpoints on one of the biggest issues facing the state.

Closing the Medicaid gap to provide tens of thousands of Idahoans with health insurance was debated in-depth at a recent public forum sponsored by American Legion Post 4 at the Bannock County Veterans Memorial Building.

The debate mostly featured Republican candidates explaining why they don’t want to eliminate the gap while not sounding insensitive to the plight of the uninsured, and their Democratic opponents countering by trying to put a human face on the problem.

Dustin W. Manwaring, a Pocatello Republican running for the Idaho House of Representatives, said he’s against accepting federal dollars to close the gap but is in favor of making sure everyone has health insurance.

“There’s a population that’s been identified to be 78,000 that’s not covered by health insurance, but I think this population is misidentified,” Manwaring said. “Any state that’s looked at this, it’s usually about double so I think it’s about 150,000 people. I do not believe we should take federal dollars and expand Medicaid in Idaho. I do think we should look for ways to make sure everybody is covered and has affordable health care.”

Pocatello Democrat David H. Maguire, who is opposing Manwaring, said the answer is that Idaho absolutely needs to expand Medicaid coverage.

“We have 78,000 people who need health care and these people are in transition,” Maguire said.

Rep. Mark Nye, a Pocatello Democrat who is running for the Idaho Senate against Pocatello Republican Tom Katsilometes, agrees with Maguire.

But Katsilometes said there really isn’t a simple answer for this question.

“There is a funding gap and I don’t know if we can count on the federal government to be able to pay for the expansion of Medicaid in Idaho,” Katsilometes said.

He fears that if Idaho closes the Medicaid gap that the federal government would not be able to provide its share of the funding in the long term.

Rep. Kelley Packer, R-McCammon, said it’s important to understand that the health care system is really ineffective and very expensive. She said she can’t support including more people in such a “broken” system.

“People cannot be turned away for health care services if they go to the emergency room. They are going to be seen and if there are other needs that they have as far as medical health care issues or concerns they will be taken care of,” Packer added. “We are not teaching people how to be healthy. We’re not trying to find ways to improve the existing situation. The reason I have not been a proponent for expanding Medicaid is because it’s broken. I believe we need to fix the system before we start including additional populations into that community.”

Firm in his opposition, Democratic House candidate Louis Archuleta, a member of the Shoshone-Bannock tribes, disagreed with Packer and said Idaho legislators need to realize that there are people behind the Medicaid gap statistics.

“My youngest son was one of those 78,000 who suffered from a very chronic disease,” Archuleta said. “He made many trips to the emergency room and owes the hospital tens of thousands of dollars. We can’t fix the program while people die or suffer from horrible debilitating illnesses. Let’s talk about people. Those 78,000 are people, not other things, not machines, not dirt, they are people and those people need health care, and it’s up to us as a state, a government and a country to provide health care to them.”

Packer took exception to Archuleta’s comments.

“I have never, ever insinuated that these people are dirt, that they were meaningless or faceless subjects that shouldn’t be cared for,” she said. “We absolutely should care for them and they are being cared for currently but in an ineffective way.”

Democratic House candidate Steve Landon of Chubbuck took it one step further and reiterated that those affected by Idaho’s Medicaid gap are people of varying backgrounds and defining characteristics.

“These are families where both adults are working full time trying to make a living, sometimes working more than one job,” Landon said. “These are students going to college and trying to raise families and get through school. These are veterans and children. They are people with faces with needs now — not a year from now, not two years from now, but right now. It’s not about the $720 million that’s sitting there from the federal government. It’s also about $2.5 million as far as indigent funds that Bannock County alone is spending every year to take care of these people.”

Landon’s opponent, Inkom Republican Randy Armstrong, said it’s premature to discuss the issue prior to the Nov. 8 election because whoever becomes the next commander-in-chief, be it Hillary Clinton or Donald Trump, would drastically impact the future of the Affordable Care Act and health care in Idaho.

“Donald Trump is completely committed to eliminating Obamacare, which will eliminate this problem completely and we’ll be back to a different system, so I’m sure we’ll have a lot of other more difficult issues to address on that point,” Armstrong said. “If Hillary Clinton wins the election, she’s committed to expanding Obamacare, which will probably cover all of these people.”

Armstrong continued, “If you’ve read about Obamacare, most of the insurance companies are withdrawing and its collapsing under its own weight. … I think that we’re probably getting compassionate and concerned about something that we really probably at some point in time in the very, very near future can’t do anything about.”

Sen. Jim Guthrie, R-Inkom, said the Medicaid gap issue is a tough one.

“I’m currently on the working group looking to find a solution to cover the gap population,” Guthrie said. “Right now in Idaho we spend about $50 million between the county and the state catastrophic fund and it used to be $75 million but the problem is Obamacare is in trouble.”

Mike Saville, the McCammon Democrat challenging Guthrie, said it’s important that the Legislature closes Idaho’s Medicaid gap.

Saville said, “Before Obamacare there’s 55 million people who didn’t have health care insurance and it is growing by 5 million a year. … There seems to be an attitude in this Legislature, this government and everybody else that it’s OK to take federal money for bridges, roads and also to not grow crops — but not to take federal money to cover 78,000 people … We need to take the money now.”