Idaho’s health insurance coverage gap
Idahoans told state lawmakers Friday morning what they thought about Medicaid expansion — including their take on work requirements or other limits on the public health insurance program, as well as their personal stories.
The 90-minute hearing before the Joint Health and Welfare Committee contained some surprises, intense moments and opinions to keep in mind as legislators debate implementation of Proposition 2, the ballot measure passed in November that made low-income adults eligible for Medicaid in Idaho.
1. ‘We do not need to be incentivized to work’
Emily Petersen, who lives in Kimberly, told the committee about her family. She and husband Earl have three kids. Their daughter, Ellie, was diagnosed in utero with spina bifida, which severely affects her mobility. Ellie weighs 72 pounds, which “already causes physical stressors for my husband and I,” and she’s growing, Petersen said.
Petersen cannot work because of the level of care Ellie needs, but they got health insurance through Earl’s job. Then, something happened that affects a lot of Idaho families:
“In the past year, my husband went through a job change that resulted in a change in benefits,” she told the committee.
The family’s income was $2,000 below the minimum to qualify for subsidized health insurance on the Your Health Idaho exchange.
“Earl and I would have to pay more than $1,000 a month” in premiums, she said. “Living at poverty level, this is not a possibility for us, no matter how much we budget.”
Petersen said her family’s experience represents that of thousands of others whose children have severe disabilities and need full-time care.
Her testimony raised the question: Would a “work requirement” rule attached to Medicaid expansion give people credit for the hours of unpaid work of caring for a family member?
“We do not need to be incentivized to work,” when their work is taking care of their children, she said.
2. I think the technical term for that is ‘clapback’
Sam Sandmire, an advocate of Medicaid expansion, testified in favor of funding implementation without any changes to the law.
“Idaho voters elected you, and you didn’t ... change that result,” she said, prompting laughter in the committee’s hearing room.
With that in mind, she told the committee, “honoring, not changing, the will of the voters is the Idaho solution.”
3. Deemed disabled, but forced to wait for health insurance
Donna Scranton is a Boise resident who worked as a behavioral therapist for children. She developed a neurological disorder that gave her seizures — painful, “scary,” stroke-like episodes during which her muscles cramp up, she told the committee.
While testifying, one of the episodes struck, visibly affecting one side of her face. Scranton carried on and finished her testimony.
She had to stop working when the seizures got worse, happening multiple times a day, she told the committee. Without a job, she had no health insurance.
“No doctor has been able to figure out what’s wrong. I’ve needed to go to a neurological specialist, but I didn’t have health insurance, and I couldn’t afford to go,” she said.
Scranton eventually was approved for disability. She was “relieved to finally realize I would have health coverage through Medicare,” she said. But then, she learned there was a 2 1/2 year waiting period before she would be allowed on the federal insurance program. She has since made it through the waiting period; with Medicare coverage, she is seeing a specialist for her disorder.
“So, you are deemed disabled by the federal government, but you are not allowed to go to the doctor unless you have cash,” she told the committee. “Implement Medicaid expansion that Idaho voters passed so that people with health conditions on disability no longer have to wait these 2 1/2 years.”
4. Those fighting expansion have their say
Fred Birnbaum, vice president of the Idaho Freedom Foundation, told the committee to consider the unknowns of Medicaid expansion.
“Although Idaho is on the cusp of expanding Medicaid, it is important that this committee and all Idahoans understand the extent to which traditional Medicaid has gobbled up resources in this state,” he said in prepared remarks to the committee.
State spending on Idaho Medicaid increased from about a half-billion dollars to about $2.5 billion in the past 20 years, he said in the remarks. “The true cost of Medicaid expansion has not been made visible to the public,” he said.
5. ‘Don’t waste time’
Nichole Stull of Boise has told her story many times — to news outlets, with other Medicaid advocates and, on Friday, to the committee.
Stull told lawmakers how the women in her family learned they had the BRCA gene, linked to breast cancer. She has it, too, she said. Her doctor’s recommendation was to get preventive surgery.
“Without health insurance, it’s not even an option,” she said.
If she were enrolled in Medicaid today, she might be able to prevent breast cancer, she said. “Instead, I will be fighting for my life when the cancer comes.”
After a cancer diagnosis, her medical care will be much more expensive, take longer and may not even save her life, she said.
“Please don’t waste time on the red tape that you could add,” she said. “There are some of us that are fighting a clock, and we need your help now.”