State Politics

Pleas from uninsured, physicians don’t sway Idaho lawmakers on Medicaid expansion

Following more than two hours of impassioned public testimony, a legislative panel reviewing health care options for thousands of Idaho’s working poor acknowledged Wednesday that it does not expect to reach consensus on what if any action to recommend to the full Legislature.

“I just don’t see us all agreeing here,” said Sen. Marv Hagedorn, R-Meridian, a panel co-chair, at the end of a daylong hearing that included testimony from approximately 40 people.

Rep. Tom Loertscher, R-Iona, the other co-chair, asked panel members to “put your ideas on paper” for discussion at the next meeting, which is Oct. 24. The panel might submit those findings in a resolution or report to the Legislature, but “for this group to come up with legislation would be foolhardy,” he said.

In the fourth hearing since convening in July, lawmakers Wednesday took public testimony for the first time from an audience that included health care providers, municipal officials, doctors and individuals at various stages of managing health emergencies on their own, without insurance:

▪ “I’m here to beg you to give me a chance to access the health care I need to live,” said Brittany Ruland, of Twin Falls, a mother of three with a “devastating” brain condition. “Our lives are in your hands.”

▪ Dr. Jon Miller, an ER doctor at Saint Alphonsus and with the Idaho Air National Guard, said emergency physicians “end up being forced to treat previously preventable disease, now at end stage,” because people postpone seeing a doctor.

▪ Aaron White of the Idaho AFL-CIO told lawmakers that health coverage for the gap group is “an opportunity to provide upward mobility” for Idaho’s uninsured.

▪ Samantha Joseph, a social worker who works with uninsured clients, said people in the coverage gap “aren’t people who want to live a life of leisure.”

▪ Another speaker, Tina DeBoer, said putting “able-bodied” citizens on a subsidy is “not a solution. ... Don’t create more dependency.”

At issue before the Legislature — yet again — is how Idaho should address the needs of 78,000 lower-income residents who don’t qualify for standard Medicaid or for subsidized health coverage on the state exchange. The Legislature has been unable to reach consensus on what boils down to two options: approving a modified expansion of Medicaid, with conditions, to cover the so-called gap population, or instituting a more limited, state-financed program.

In the morning, the panel heard local and national organizations that oppose federal health subsidies characterize such programs as financial black holes that breed dependence in the populations they serve.

Gregg Pfister, testifying for the Foundation for Government Accountability, which lobbies nationally against Medicaid expansion, told lawmakers that the gap population “is a problem with an easy solution. It’s employment. These people need work, not welfare.”

Proponents of a federally funded but state-managed option to meet the health care need challenged the dire financial predictions and said that private and charity-based solutions to paying for health care already are at capacity or just not up to the task.

“Charity care options are not viable options to close the gap,” said Mindy Hong, executive director of the Pocatello free clinic, whose clients all lack health coverage.

Dr. Bruce Belzer, a family physician and president of the Idaho Medical Association, said there’s “virtually no debate” among the IMA’s members “about what should be done. We need a comprehensive solution for these (uninsured) patients.”

Bill Leake, a Teton County commissioner and a member of the Idaho Association of Distract Boards of Health, also urged panel members to support a comprehensive solution for the gap group.

Elting Hasbrouck, a Valley County commissioner, cited a need for “some personal responsibility for these people that are in the gap.”

Travis Applebaum, who suffers from chronic pain, told the panel he now has coverage as an instructor at Boise State University. But he has been in the gap before and could be again, and working more is not an option for him.

“My health hinders me from pursuing full-time work,” Applebaum said.

Bill Dentzer: 208-377-6438, @IDSBillD