Idaho Lawmakers Take Up Medicaid Gap Problem... Again 

click to enlarge KELSEY HAWES
  • Kelsey Hawes

Lawmakers from both sides of the aisle in the Idaho House and Senate spent a lovely summer Wednesday morning huddled across a Statehouse conference table, once more trying to find a way forward to solve the state's Medicaid gap dilemma.

Politics—and particularly partisanship surrounding President Barack Obama's Affordable Care Act—have hindered Idaho lawmakers from finding a solution for the tens of thousands of Idahoans who earn too little to apply for subsidized insurance on the state-run exchange, but too much to qualify for Medicaid-funded services. 

While many states have expanded their Medicaid rolls, accessing tens of millions of dollars of federal funds, the GOP-driven Idaho Legislature has been wary of joining those ranks.

"The objective for today is for everybody to get the same baseline of understanding," said Sen. Marv Hagedorn (R-Meridian), co-chair of the "Healthcare Alternatives for Citizens Below 100 Percent of Poverty Level Committee."  

Ultimately, Hagedorn and co-chair Rep. Tom Loertscher (R-Iona) said the committee's goal would be to find recommendations to bring to the 2017 Idaho Legislature. Those recommendations would include, they said, some way to request a federal waiver that would allow Idaho to take ACA Medicaid expansion funds but use them instead for a state-run program to serve the gap population.

"Currently, we're seeing about 37 percent of our clinics' patients being uninsured. Some clinics are as high as 60 percent uninsured," said Yvonne Ketchum-Ward, CEO of the Idaho Primary Care Association. "Some of our health centers say they get by $5 dollars at a time because that's what patients can pay."

Rep. Fred Wood (R-Burley), who joined the committee via phone, said he would favor using funds from the Idaho Tobacco Master Settlement to help pay for some care for the neediest in the Medicaid gap population.

"The funds go on for perpetuity, interestingly enough. All we need to do is to divert that money into this particular program," said Wood. "To be blunt, a lot of people feel that there are much better uses for that money."

Idaho Department of Health and Welfare Director Dick Armstrong told the panel his support for Governor C.L. "Butch" Otter's $30 million proposal to fund some health assistance for the gap population fell on deaf ears during the 2016 legislative session.

"I thought it was a grand idea, but it lost support. It didn't really do anything to solve the problems of counties' indigent funds or hospitals' problems with the uninsured. A lot of early supporters said, 'That's like kissing your sister. This isn't good,'" said Armstrong. "And at the end of the day, it was a lot of money, competing with a lot of other needs."

It was noon before lawmakers wrapped up the July 20 session, promising to reconvene every three weeks until they could craft a few solutions to put before next year's Legislature. The next meeting was tentatively set for Thursday, August 11.
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