BOISE • Gov. Otter announced his support Thursday for a plan to extend primary care coverage to the uninsured and emphasized that taxes will not be raised to pay for it.
Flanked by Department of Health and Welfare Director Dick Armstrong and Health and Welfare committee chairmen Republican Sen. Lee Heider, of Twin Falls, and Burley Republican Rep. Fred Wood, C.L. “Butch” Otter told the crowd of reporters, lobbyists and other Capitol regulars at the Associated Press’s session preview that the proposed Primary Care Access Program would help the uninsured without making Idaho dependent on the federal dollars that would have come with Medicaid expansion.
“We believe this is an Idaho solution to try to provide for those in the gap,” Otter said. “Is it a total solution? I would be misleading you if I said that it was.”
Armstrong also touted the health benefits of the plan, which would pay $32 a month to qualified providers to provide primary care services and develop treatment plans for them.
“That will lift many of their conditions from marginal to healthy,” Armstrong said.
It would not cover other medical needs such as hospitalization or prescriptions, and participants would cover part of the cost through an income-based, sliding-scale fee. The administration is proposing to fund it with cigarette and tobacco taxes — not by raising them, but by redirecting an estimated $32 million a year in these taxes to the new health care program and finding other funding sources for several programs, including aquifer recharge and some state highway money, that are funded with cigarette taxes now.
An estimated 78,000 Idahoans fall into the “Medicaid gap,” where they don’t qualify for Medicaid but don’t make enough to qualify for tax credits to buy insurance on the state-run exchange. Idaho lawmakers have declined to expand Medicaid coverage to all of the poor, which was originally required under the Affordable Care Act but became a state option after a 2012 Supreme Court ruling.
House Speaker Scott Bedke, a Republican from Oakley, said that nobody in the Legislature believes that the current system of caring for the uninsured with the catastrophic health care fund and in emergency rooms is a good one. He said he didn’t know if the proposal would pass, but that the health committees would “take this up and they’ll fully vet it.”
Assistant Minority Leader Mat Erpelding of Boise criticized the plan as a “halfway solution” that would cost more for Idaho taxpayers than Medicaid expansion, which Idahoans are helping to fund in other states with their federal tax dollars, would. Close the Gap Idaho, an advocacy group that supports full Medicaid expansion, released a statement Monday that offered some praise for the plan but said it didn’t go far enough.
“We applaud Gov. Otter and Director Armstrong for engaging the Legislature in a conversation that is absolutely critical to tens of thousands of fellow Idahoans who have no access to comprehensive health care coverage,” said Brian Whitlock, president of the Idaho Hospital Association. “This proposal is an initial step, but it is an incomplete solution. The conversation won’t be complete until we have a system in place that not only makes fiscal sense, but also utilizes resources efficiently and effectively to provide appropriate coverage for our fellow Idahoans.”
Senate President Pro Tem Brent Hill, a Republican from Rexburg, said that adopting the home health care plan wouldn’t preclude lawmakers from doing more to help the uninsured in the future.
“It’s not lost on us that we’re dealing with people’s lives here,” he said. “This is a serious issue. This is a real issue.”