As physicians, we care about our patients. We want them to be as healthy and productive as they can be. As emergency medicine doctors, we see patients when they are usually in a medical crisis due to illness or injury. That crisis is made worse if they are among the 78,000 Idahoans in the health care coverage gap. During the 2016 legislative session, we joined other physicians and medical professionals who spoke out in support of Idahoans who are lost in the coverage gap. We called our legislators, sent them emails, testified in committee and met with legislative leadership.
We spent this time because we know that patients without health care coverage are much more likely to suffer needlessly from preventable medical conditions, and often delay treatment of illness and injury until it becomes prohibitively costly. As emergency physicians, we can say with confidence that Idahoans die or are left debilitated due to lack of health care. No one who comes to the ER gets turned away if they don’t have insurance. We are required by the Emergency Medical Treatment and Active Labor Act, enacted under President Ronald Reagan, to provide care to patients in the ER. Because of the coverage gap, we all pay the cost for this care with our tax dollars through county and state indigent funds.
Despite our efforts and the efforts of thousands of Idahoans, the Legislature failed to close the coverage gap, ignoring the voices of those lost in the gap, as well as the clear and common-sense recommendations of the Governor’s Medicaid Redesign Work Group.
This is disappointing for many reasons. It will result in costly trips to the ER for conditions that could have been treated earlier for less. For patients who are maimed and not able to work, families are left in economic despair. And, most importantly to us, it will result in pain and suffering for many of our patients.
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We are encouraged that the Idaho House of Representatives has committed to forming a work group to study the gap population. Finally, legislators are working toward a solution. It is starting to look as though closing the gap is a matter of “how,” rather than “if.”
But it must be said that this issue has already been studied in depth. Thirty-one states have already closed the gap. Legislators and medical experts alike served on the Governor’s Medicaid Redesign Work Group. They offered recommendations that make sense medically and financially.
We know who falls into the gap population. These are 78,000 Idahoans who work for low wages. They work in food service, agriculture, construction and office jobs. Idaho has the second-highest rate of uninsured veterans in the nation. These are people we come into contact with every day and they are people who have served in the military on our behalf. More study cannot be an excuse to avoid doing something.
As long as there are Idahoans in the coverage gap, this issue is not going away. Until the coverage gap is closed in Idaho, we will continue to speak out for the best interests of our patients. We call on legislators, especially those assigned to the new work group, to set aside ideology and politics and try to see the gap population the way we do: as working Idahoans who just need a little help.
Dr. Heather Hammerstedt, MPH (Master of Public Health), is on the board of directors of Idaho Emergency Physicians and is executive director of Global Emergency Care Collaborative. Contributing authors: Po Huang, M.D.; Eric Kraska, M.D.; Darin Lee, M.D.; Benjamin Cornett, M.D.; and the other 35 emergency physicians making up Idaho Emergency Physicians.