Idaho lawmakers introduce $10 million health-gap bill

BOISE – Idaho is looking at launching a $10 million program to care for some adults who fall into the state’s health care coverage gap.

An Idaho House committee voted unanimously Monday to introduce legislation to launch a new state Health Care Assistance Program, which would tap the state’s Millennium Fund to provide primary care and limited prescription coverage.

“Because of the finite funds available, this program will only cover a limited subgroup of adults and is not comprehensive care,” Rep. Fred Wood, R-Burley, told the committee, which he chairs. The services would be for adults who earn less than 100 percent of the federal poverty level; aren’t eligible for either Idaho’s limited Medicaid program or subsidized insurance through the state insurance exchange; and are uninsured.

Wood said the program would be designed to “further the state’s goal” to move away from fee-for-service delivery of health care into managed care. The legislation also provides spending authority for up to $500,000 next year in grants or charitable donations to the program, to bring it to a total of $10.5 million.

Rep. Mike Kingsley, R-Lewiston, told Wood, “This is such an important thing for Idaho. I know there’s another bill out there to do something similar to this.” But he said he thought Wood’s bill would help “indigent people that are suffering,” and said, “I just am glad that this is coming about and we’re discussing it. For Idaho, we can do better, we can get primary care going.”

Currently, earnings from Idaho’s Millennium Fund, an endowment set up from proceeds of a nationwide tobacco settlement, go to various health-related programs, from the Idaho Meth Project to substance abuse treatment programs at the Idaho Department of Correction. This year’s distributions totaled $9.6 million; another $3 million went undistributed.

Wood’s proposal would displace many of the health programs that now get funding from the Millennium Fund each year, but still would allow funding for tobacco cessation and prevention programs. It bears some similarities to Gov. Butch Otter’s failed legislation from last year to set up a $30 million “Primary Care Access Program” with state general funds, to provide limited primary care to the full gap population. But it has only one-third the funding.

Asked how the program would determine which of those who are eligible can enroll, Wood said, “Basically on a first-come, first-served basis.”

He said the proposal would still leave roughly $6.2 million in Millennium Fund earnings to be distributed to other programs next year.

Wood said he’s developing a list of co-sponsors; Sen. Marv Hagedorn, R-Meridian, who co-chaired a joint working group on the health coverage gap this year, will be the lead Senate sponsor, Wood said.

Idaho has an estimated 78,000 residents who make too much to qualify for Medicaid, but not enough to qualify for subsidized health coverage through the state’s successful Your Health Idaho insurance exchange. The exchange recently reported record enrollments of nearly 106,000 for the coming year.

The gap comes because Idaho hasn’t expanded Medicaid under the national Affordable Care Act, as most states have done; that allowed those states, including Washington, to cover their gap population largely at federal expense.

Idaho Department of Health and Welfare Director Dick Armstrong applauded the introduction of the bill, which he called “not a bad building block.” He said, “It acknowledges the Legislature thinks there’s a problem.”

Idaho’s coverage gap has been blamed for numerous deaths among the state’s uninsured; health advocates and other have been pressing for Idaho to close the gap for the past four years. Several task forces convened by Gov. Butch Otter recommended expanding Medicaid to close the gap, but lawmakers were unwilling to take that step.