POST FALLS - A controversial plan to expand Medicaid in Idaho won't likely be acted on during this legislative session because it's too fresh and would mean a major health care shift, a state health official said on Tuesday.

"It's a complicated program," Denise Chuckovich, Idaho Department of Health and Welfare deputy director, told about 150 Post Falls Chamber of Commerce members at Red Lion Templin's Hotel.

She anticipates a lot more discussions before decisions are made.

"We're trying to change the way people access health care," Chuckovich said. "We're trying to build a plan where people are accountable, one that focuses on keeping people healthy rather than waiting until they're in the hospital when care is most expensive. If we design the right model, we think we'll see a difference in behaviors."

The plan, which would expand Medicaid to another 104,000 low-income people and replace an existing program that pays the costs of the medically indigent, was introduced at the Legislature last week in a package to eliminate Idaho's catastrophic health care program.

The proposal provoked strong feelings at the chamber lunch.

Ron Nilson, CEO of Ground Force Worldwide, said while the plan may reduce the financial burden on Idaho due to more federal funding involved, he's skeptical whether it will make a difference in the end to the taxpayer.

"To the average taxpayer, it doesn't matter if you're paying the state with the left hand or the federal government with the right," he said.

One man said some employers may cut employees' hours so they qualify for the Medicaid expansion plan and, if they do, he wonders if that will make even more people qualified than what's anticipated and taint the model.

Mike Baker, CEO of Dirne Community Health Center in Coeur d'Alene, which provides low-income people with care and has served on a working group to explore the expansion, said there are a lot of sides to the debate but the goal is having access to affordable care.

"We've spent a lot of time on data," Baker said. "We have to play the game. We may not like the game that's there, but it's the reality."

Chuckovich said that while health care has been and will remain a hot topic, the system is in need of repair.

"There's so much turmoil in the health care system," she said. "It'll be a rocky couple of years until we get a (health insurance) exchange in place."

The U.S. Supreme Court last year decided to make Medicaid expansion under the Affordable Care Act, known as Obamacare, optional.

Idaho Gov. Butch Otter then appointed a working group, which also included Chuckovich, to evaluate the potential impacts on Idaho of Obamacare's expansion of Medicaid benefits to citizens whose incomes are up to 138 percent of the poverty level - roughly $31,000 a year for a family of four.

Recommendations from the group included: aligning member and provider incentives, requiring financial participation in health care, incentivize members to be cost-conscious consumers, a focus on primary/preventative care and refining data systems to improve transparency with providers, payers and policy makers.

Rep. Tom Loertscher, R-Bone, who introduced the Medicaid expansion bill, said it's a necessary long-term solution to cover the escalating medical bills of Idaho's indigent population. He said replacing the catastrophic health care program with Medicaid will save Idaho's local property taxpayers $478 million over the next decade.

Loertscher helped create the shared state-county indigent medical program in the mid-1990s, but said it has outlived its usefulness because costs have escalated to more than $60 million annually.

Under Obama's overhaul, the federal government will initially pay for 100 percent of newly eligible Medicaid beneficiaries. Many of those newly eligible people, largely single adults, now fall under the catastrophic health care program.

But Idaho has the choice of whether to go along, after the U.S. Supreme Court said the federal government couldn't force states to do it.

The expansion proposal could be implemented as soon as next year.

Otter hasn't endorsed Medicaid expansion despite a recommendation to do so by the working group. In January, Otter said he first wants to see reforms to the federal-state health care program, including provisions that require more patient responsibility.