A lot has changed on the health insurance landscape since July at the first meeting of the Idaho Legislature’s interim committee formed to study ways to help the 78,000 people in this state without coverage because they fall into the so-called Medicaid gap.
But political events since the Oct. 24 meeting of the Legislature’s Healthcare Alternatives for Citizens below 100 percent of Poverty Level work group have been profound. The election of Donald Trump, combined with the GOP’s success in preserving majorities in the House and Senate, sets the stage for changes to the landmark 2010 Patient Protection and Affordable Care Act we often call Obamacare.
Nobody knows what the future is for Obamacare or health care in general. Republicans are indeed in a position to “repeal and replace” the federal system, though not as quickly or as easily as some might imagine. President-elect Trump appears to be adding a softening “r” word to the equation: “revise and replace.” He and others from both parties see the value in existing components of the law, such as the provisions to cover people with pre-existing medical conditions and allowing family policies to continue insuring children up to age 26.
But the options for covering our Idaho neighbors in the gap population — those who make too much to qualify for Medicaid and too little to be able to afford insurance on the Your Health Idaho exchange — seem greatly diminished. And there is lost support from key legislators defeated on Nov. 8: Sen. Dan Schmidt, D-Moscow, and Rep. John Rusche, D-Lewiston, both doctors and champions for our uninsured.
The Idaho health insurance committee has looked into options, such as Medicaid expansion, that would take advantage of waivers and federal money to bring coverage for those without it. But the uncertain future of Obamacare all but rules that out. Though some states have petitioned that their successful Medicaid expansion programs be “grandfathered in” if policies change, there is no assurance that will happen.
When the committee gathers again at 9 a.m. Tuesday for its final meeting, we implore its 10 members to focus on several things that have not changed because of any election:
▪ Those 78,000 people, most of whom are the working poor, will be without health insurance coverage and routine care until the Legislature comes up with a plan.
▪ Among those in the gap, many will “live sicker and truly die younger,” according to testimony by Dr. Ted Epperly, president and CEO of Family Medicine Residency of Idaho.
▪ The committee has worked long, hard and honestly to identify and define the problem of the uninsured, and the reasons behind health care costs in Idaho. It is time to solve the health care insecurity of Idahoans whose annual income falls in the $11,000 to $16,000 range.
During this time of Thanksgiving, there is just one way to look at this: These are still our neighbors, and providing care options for every Idahoan is the right thing to do.
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