State Politics

Idaho paid $8M for 2,400 psych hospitalizations. Guess how much therapy that buys under Medicaid?

How much mental health care does $8.5 million buy? That answer changes for Idaho’s poorest citizens after voters passed Proposition 2.

Idaho’s counties spent more than $8 million on emergency mental health care for Idaho’s poor uninsured adults in the 2018 fiscal year, according to data from the state’s Catastrophic Health Care Program.

For the same amount of money, the state could have provided about 2,270 people with weekly psychotherapy and monthly psychiatric visits for a year under expanded Medicaid, based on 2018 rates, a Statesman analysis has found. (That doesn’t include the cost of prescription medication, which varies widely.)

Idaho voters this month approved an expansion of Medicaid to cover adults who are low-income and childless, which is expected to relieve much of costs for counties that have previously spent millions on emergency mental health care services. There are at least 20,000 to 25,000 Idahoans in the Medicaid gap who currently have no insurance and have a serious mental illness.

Idaho’s counties last year fielded 2,376 mental health claims for “indigent” patients who were unable to pay — 49.7 percent of all claims that came in. Mental health claims routinely flood the indigent program, outpacing the number of claims for car accidents, heart attacks and chronic diseases combined.

The indigent program pays medical providers when they take patients who can’t afford care. For example, it may cover an emergency room visit for someone in psychosis who is uninsured and jobless. Some patients have multiple claims in the year.

Funds to pay indigent medical claims come from property taxes, collected from homeowners and other property owners in each county. Last year, Ada County spent $3.9 million and Canyon County spent $2.3 million on emergency mental health care, and those costs were rising.

The Statesman’s analysis is based on fiscal year 2018 data from the state’s Catastrophic Health Care Program and 2018 reimbursement rates for Idaho Medicaid. The state fiscal year ended June 30.

Related stories from Idaho Statesman