State Politics

With few specifics, Idaho lawmakers urge action on health care for gap group

The Legislature’s health care alternatives panel met Tuesday and approved a set of recommendations for action in the 2017 legislative session.
The Legislature’s health care alternatives panel met Tuesday and approved a set of recommendations for action in the 2017 legislative session.

Idaho lawmakers reviewing health care options for the uninsured stressed the need for the state to act, regardless of uncertainty at the federal level over the future of President Obama’s health care initiative.

“Doing nothing is not an option,” said committee co-chair Rep. Tom Loertscher, R-Iona.

The committee backed no specific proposal Tuesday, instead issuing legislative recommendations that keep multiple options open, including potentially expanding Medicaid to cover the group.

The panel’s unanimous final report acknowledged that this month’s election essentially moved the field on which their four-month deliberations had played out.

“Let’s not do inaction based upon the past election results,” said Rep. Fred Wood, R-Burley. “That to me is foolish.”

Convening in July, the panel was asked to review and recommend how the state could provide health care to 78,000 low-income Idahoans who currently lack coverage. The so-called gap group is caught between the upper income limit for traditional Medicaid assistance and the lower limit for insurance subsidies available on the state health insurance created under Obamacare.

Over four months and six public sessions, the panel received testimony from dozens of advocates representing all sides of the health care debate, as well as in-state and out-of state health care professionals and government officials.

The panel’s succinct report includes these recommendations:

▪ The 2017 Legislature should enact “some kind” of health care plan for the gap population.

▪ Any plan that involves expanding Medicaid to cover the gap group should include a sunset clause “in the event that federal policy changes.” Expanding Medicaid to cover individuals up to 138 percent of the federal poverty level is a key component of Obamacare.

▪ All of the various populations served by Medicaid in Idaho “should be moved to managed care as soon as possible.”

▪ Any state-funded program should include “a direct care component for primary and preventative care.”

▪ The cost of any state program or the state’s share of Medicaid expansion costs should be covered out of the state’s tobacco industry settlement fund or general fund.

Beyond the question of care for the gap group, the panel’s recommendations urge immediate action to improve the state’s primary health care services to reduce costs from less-serious health care problems that balloon into major conditions from lack of treatment.

“I’ve never been totally opposed to taking federal money,” said Sen. Steven Thayn, R-Emmett. “My major point has been we have to rebuild the primary care network. Regardless of what Congress does, this is an area we need to focus on and we need to get started right away.”

The state has a four-year, $40 million federal grant aimed at reforming state health care and moving away from the current fee-for-service-based model that inflates costs.

Panel co-chair Sen. Marv Hagedorn, R-Meridian, said it was now up to the 10-member panel to “carry what we’ve learned to the other 95 legislators that we deal with. They’ve got to understand to the best that they can what we understand now.”

Bill Dentzer: 208-377-6438, @IDSBillD