CAT fund requests level budget, but ‘concern is what goes down could go up’
Roger Christensen, chairman of the Catastrophic Health Care Fund board and a Bonneville County commissioner, told the Joint Finance-Appropriations Committee this morning that the fund is requesting the same budget for next year as it had this year: $18 million. “As you know, the current uncertainty in health care makes this a very challenging thing to predict,” he told legislative budget writers.
Yesterday, program Director Kathryn Mooney told the House Health & Welfare Committee that indigent care costs in Idaho could jump by more than $20 million per year if the Affordable Care Act is repealed, Lewiston Tribune reporter Bill Spence reported; his full report is online here.
Christensen said costs for indigent care in Idaho, which is shared between county property taxes and the state fund, have been falling as patients have found other resources – including subsidized insurance through the state health insurance exchange. “The indigent program, we’re the payer of last resort,” Christensen said. “We’re not a health program. We screen and pay bills for emergent cases.”
Costs have been fairly stable over the last couple of years, he said. “Normally when you have things happen, loss of resources, change of resource, it takes about a year to get to the state level for funding,” he said. “So if we see changes, we’ll have kind of an idea that they’re coming. But right now, it seems like they’ve kind of leveled off.”
In fiscal year 2016, the costs for the program, between counties and the state, was $33.9 million. That was down from a high of $56 million in 2012.
Christensen said total cases this year are up 7.5 percent over last year, but total dollars are down, “in the area of 7 percent.” He said, “One of the most concerning trends, especially for counties on the indigent fund, is in the area of mental health. That’s where we continue to see increases. The majority of those increases are happening at the county level.” That’s because the state fund kicks in for cases that exceed $11,000, but most of those cases involving protective custody holds for mental health issues “don’t rise to the dollar amount to where the CAT fund picks up,” he said. “The CAT fund used to pay a much larger proportion for counties. Last year, the counties were just slightly below, and this year they’ve crossed for the first time.”
With all the uncertainty on the health care front, Christensen said, “Our concern is what goes down could go up.”
