Capitol & State

Revisiting average CAT case costs

The average cost of medical cases covered by the state Catastrophic Health Care fund is indeed rising, but by less than I reported Monday.

The CAT fund covers the state’s share of big medical bills that low-income or uninsured Idahoans can’t pay. County indigent funds cover the first $11,000 of those bills; the state picks up the rest. People who get their bills paid this way get liens placed on their personal property.

Monday’s story noted how CAT fund expenses have declined as more Idahoans have obtained health insurance. With the 2013 creation of the state health insurance exchange under the Affordable Care Act, about 86,000 more Idahoans have insurance now than before. As a result, total state and county costs for indigent care have declined dramatically, along with the total number of cases.

That said, as legislative budget writers and others heard Thursday from CAT fund overseers, the average cost of cases covered by the state has hovered either side of $26,000 since 2012, with a slight uptick for the period June to December this fiscal year. I had higher cost figures and a steeper rate of increase – since removed from the story – because I was averaging the number of cases against both state and county costs.

There’s still concern that a state budget proposal to subsidize basic preventive medical care for low-income, uninsured Idahoans might send CAT fund costs creeping up again as people go to the doctor, find out they’re sick, and need treatment that isn’t covered. If the Legislature doesn’t approve the basic care plan, CAT fund expenses might continue to drop a bit, since insurance enrollments from the exchange look to be higher again this year.

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