Gov. Butch Otter’s Medicaid Redesign Work Group met all day today, and at the end, voted 10-3 in favor of accepting federal Medicaid expansion money to cover low-income uninsured Idahoans with contracted health plans focused on primary care and prevention; you can read my full story here at spokesman.com. Sen. Steven Thayn, R-Emmett, who cast one of the three “no” votes along with Reps. Mike Moyle, R-Star, and Tom Loertscher, R-Iona, said while he opposed the motion, he liked that the group included plans for a pilot program in using existing catastrophic care fund money to provide direct primary care to patients.
Thayn said for him, there are still unanswered questions, including how much federal authorities will let Idaho vary from regular Medicaid rules in its plan. “That’s probably the biggest piece: How’s it going to be different than regular Medicaid?” he asked. “Because we don’t necessarily want, and I think the task force agreed with this, to expand the current Medicaid plan just the way it is.”
The group heard a full day of presentations, including consultants’ analyses, and presentations on “special gap populations” that are now missing out on coverage, including veterans, the disabled, people with mental illness and many with indigency claims. “There’s no question that something needs to be done,” Thayn said. “Do we need federal money to do it? Could we incorporate that into some other ideas? Those are all debate points, I guess.”
States had the option of accepting millions in federal funds to cover those who make too much to qualify for Medicaid, but not enough to qualify for health insurance subsidies through insurance exchanges. Idaho has repeatedly delayed its decision, while Washington accepted the money and expanded coverage. An earlier state task force that Otter convened voted overwhelmingly in favor of expansion, but the governor proposed no legislation on that last year.
Among the other options the working group considered today were sticking with the status quo; accepting the federal money but using it to buy private insurance along the lines of what Arkansas has done; and providing direct primary care services to patients with the existing catastrophic fund, which is 100 percent funded by the state and local property taxes. There's more info here about today's meeting.
Thayn said, “Can we craft it in such a way that it can win conservative legislators’ support? … I’m going to work on that a little bit and come up with some ideas. I don’t know if it’ll be accomplished or not.”
Corey Surber of St. Alphonsus, who facilitated the working group, said its recommendation will be written up in a report and presented to Otter. The option the group voted for would cover more than 100,000 Idahoans who now lack health insurance, and would save state and local taxpayers an estimated $43.9 million in fiscal year 2016 if lawmakers approved it in their 2015 session.