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New legislation will limit eligibility for county indigent medical claims
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New legislation will limit eligibility for county indigent medical claims


RUPERT — Some residents who need help to pay medical bills across the state will no longer get help from the their counties when new legislation takes effect.

Anyone who is eligible for Medicaid or insurance through the state’s insurance exchange will no longer be eligible for county assistance through the indigent program and the state catastrophic health care fund.

“The Legislature decided the state of Idaho will be ruled by personal responsibility,” Minidoka County Commissioner Wayne Schenk said.

The law will take effect July 1 but counties will begin implementing the changes in 2022 and fully in 2023.

The county medical indigent program currently operates as a loan for people who are unable to pay their medical bills up to $11,000, according to Susan Keck, who facilitates the indigent claims for Cassia County. The cap amount is the same for every county.

The amount of the remaining bills over the county’s cap amount is then sent on for approval through the state’s catastrophic health care fund.

Applicants set up payment plans to repay the money. If the money is not repaid the county can issue a lien on the person’s property. But this will now change under the new law.

Schenk said the new funding changes are tied to Medicaid expansion.

Under House Bill 316, anyone who qualifies for Medicaid or insurance through the insurance exchange will be prevented from receiving assistance through the county program and the state’s health care fund.

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The legislation also eliminates state funding for public health districts.

Cassia County Commissioner Bob Kunau said the changes in the law will require the counties to pay an increased allotment of money to the public health districts. That money would have gone to county medical indigent claims.

“Hospitals will have to take on some of it,” Kunau said, about some of the medical bills that will remain unpaid. “The hospitals will have to file the liens and set up the payment plans.”

Kunau said Cassia County expects to save a projected $40,000 to $50,000 in 2023 when the funding shift is completed.

Schenk said the county’s indigent fund comes from its own levy and includes budget amounts for attorney fees and burials for indigent people. The new law will only affect the medical portion of the budget.

The legislation also includes an amendment regarding public health districts to ensure the districts can continue with existing administrative relationships with state agencies if desired along with language clarifying that local health district boards are responsible for setting salaries of local health district officials.

In fiscal year 2022, the state general fund will see a savings of $4.9 million when the state no longer supplies aid to public health districts.

In fiscal year 2023 and the years after the savings will go up $9.8 million and raise $8.5 million due to savings to the state’s catastrophic health care fund.

In 2022, the state’s counties will save $6 million in indigent fund expenses and those savings will provide $4.9 million in additional funding to public health districts.

In 2023 and the years after, the counties will save $12 million in indigent fund expenses and $9.8 million of the savings will provide funding to public health districts.


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