On January 7th of this year, Governor Otter proposed a new solution to provide basic primary and preventative care services to about 78,000 Idahoans who are currently uninsured. The 30 million dollar initiative, however, was voted down by the House State Affairs Committee 8-6. Lack of a clear source of funding was one of the reasons the committee gave for killing the new legislation.
The program was designed to help those Idahoans who do not qualify for traditional Medicaid and who aren’t paid enough to qualify for help getting coverage on Idaho’s health care exchange. This gap exists in about two dozen states as a result of a Supreme Court ruling that individual states could opt out of the expanded federal Medicaid program. Idaho is among the states that do not participate in the Medicaid expansion.
The Governor’s program, PCAP (Primary Care Acccess Program), attempted to close this gap. By creating a payment system to community health centers, PCAP would have helped identify those in the gap and provide basic primary and preventative care services to this population – basic lab, x-ray, pharmacy and limited behavioral health services. But what PCAP failed to cover is the management of chronic diseases like diabetes or cancer.
Originally, the plan was going to be funded through additional taxes on tobacco but those dollars were earmarked for other programs. In an effort to keep the bill moving forward, legislators identified the Millennium Fund, a trust fund whose earnings are used each year to pay for health-related programs, as a source of funding. But the full amount of 30 million dollars to fund the program could not be identified which led to the bill being voted down.
The plan can be reworked to fill in the gaps in the funding model and brought back for a vote, but the feeling from the bill’s sponsors is that it is most likely dead. There is not much support in the legislature and those in the medical field feel it doesn’t do enough to address the real problem.
An alternative proposal to expand Medicaid was brought to the Idaho Senate Health and Welfare Committee by Senator Dan Schmidt of Moscow. The bills, SB1204 and 1205 were heard in an informational hearing but a vote is not expected on either bill. These bills which would close the gap with full coverage for these Idahoans has the support of most medical facilities and providers in the state. However, there does not appear to be much support for it in the legislature as it requires federal funding tied to the Affordable Care Act.
With no new legislation on the horizon addressing this serious issue, Idahoans living in this gap will not see relief any time soon. For now, community health centers like Heritage Health will have to do what they can to reach out to this at risk population and help them get the preventative care they need.