Every Tuesday morning at 9, they file in, some crying, some defiant - all with big medical bills they can't pay, pleading with Kootenai County commissioners for help. “It's at times frustrating, and at times gut-wrenching,” said Commissioner Dan Green, “especially when I have people that really need the help and then they don't qualify for the program, and then I see people that we are forced to help that think it's some sort of entitlement.” The scene is repeated in each of Idaho's 44 counties, which state law makes the last resort for uninsured patients who can't pay their medical bills.
Idaho's unique system for paying the catastrophic medical bills of indigent patients - which relies solely on local property taxes and the state's general fund - may make it the state that would benefit the most from the expansion of Medicaid under the federal Affordable Care Act, which would expand the federal-state medical insurance program for the poor to cover the same population that now is thrown on the mercy of county commissioners - and do it almost entirely with federal funds.
If Idaho were to replace its current system with a Medicaid expansion, the state and its county property taxpayers could save hundreds of millions of dollars over the next six years, according to a Spokesman-Review analysis of current and projected costs. But some prominent Idaho politicians already have come out against the move, saying they want no part of “Obamacare.” You can read my full story here from Sunday's Spokesman-Review.