As a fourth-year medical student from Idaho and a future family physician, I regularly care for uninsured patients living in the coverage gap. These folks make too much to qualify for Medicaid, but not enough to afford insurance through the Your Health Idaho exchange. Many of them are struggling to live making the minimum wage. Their compelling stories motivate me to advocate for access to affordable, effective health care for all. In addition, this issue will soon become personal when I turn 26 next month.
Thanks to a popular Affordable Care Act (ACA) provision, I have been covered under my parents’ health insurance throughout college and most of medical school, but that will soon end. Soon after my birthday I will become uninsured. It feels like being evicted from the health care system, which is rather ironic given my future profession.
As a full-time medical student, my net income is $0 per month. Like many of our peers, my wife and I depend on federal loans to pay for our education and living expenses. One might assume we would qualify for Medicaid or other subsidized coverage, but in Idaho, that assumption is false.
Since Idaho has not expanded Medicaid, I have nowhere to turn for affordable health insurance. According to YourHealthIdaho.org, the most affordable option available to me is a $382-per-month catastrophic plan. It includes a $7,000 deductible, a $35 copay for up to three primary care visits, and no pharmaceutical coverage until the deductible is met. This is minimal coverage at best; it’s tough to justify this cost when facing compounding 6 percent interest on every dollar I spend.
Last year, I went to the doctor once. Fortunately, I’m young and healthy. But what if I were born with Type I diabetes and my life depended on daily insulin? How would I pay for that? More loans, I suppose.
For years, our Legislature has failed to close the Medicaid coverage gap, which has left the estimated 78,000 Idahoans who would gain coverage in limbo. Sadly, political divisions have obscured the real issue at hand — human lives. Expanding Medicaid under the ACA would have saved 76 to 179 lives annually and created roughly 15,000 jobs in Idaho. Instead, Idaho failed to act and lost approximately $184 million in savings. It’s unclear how these numbers would change under the recently released Republican plan, the American Health Care Act (AHCA).
Many Idaho legislators have put this issue on hold again this year, waiting to see if Congress repeals the ACA. I have read the House Republican proposal and while it has many flaws, it does not repeal Medicaid expansion outright. In essence, it gives Idaho one last chance to expand. Under the proposal, significant federal funding is still available to expansion states through 2019, and at a lower rate afterward. We cannot continue tolerating inaction. If Idaho fails to expand Medicaid again, that failure is on us, not Congress.
Matt Peters is a fourth-year medical student from Eagle in the University of Washington WWAMI program.