Otter’s health plan: ‘It’s Idahoans taking care of Idahoans’
Here’s a link to my full story at spokesman.com on Idaho Gov. Butch Otter’s proposal today for a new $30 million program to provide basic preventive medical care to the estimated 78,000 Idahoans who now fall into the “gap” population, making too much to qualify for Medicaid but too little to qualify for subsidized health insurance through the state health insurance exchange. “We’re going to do this at home, it’s the Idaho solution,” Otter said. “Is it more expensive? In the long run, probably not, but in the short term, yes, it is more expensive to do it, but it’s Idahoans taking care of Idahoans.”
That’s as opposed to expanding Medicaid, which would provide full coverage to those in the gap and save the state hundreds of millions of dollars. But the state Legislature hasn’t been interested, despite repeated proposals from an Otter task force.
Reaction from health officials was mixed. “This proposal is an initial step, but it is an incomplete solution,” said Brian Whitlock, president of the Idaho Hospital Association. Dr. Ted Epperly, CEO of the Family Medical Residency of Idaho, said it’s “only a partial plan that provides limited benefits.”
The plan calls for Idahoans aged 19-64 who fall into the gap – earning less than 100 percent of the federal poverty level and not qualifying for any other health insurance – to enroll at a participating clinic in their area, where they’d get an initial health assessment and an ongoing plan for addressing their health care needs. It’s a “patient-centered medical home” program, a managed-care approach that focuses on coordinating care that’s appropriate for each patient’s needs. Fees for services would be charged on a sliding-fee basis according to income; the state would pay the clinics $32 per patient.
Not covered: Hospitalization, emergency room care or specialty services. But the program would provide basic preventive, physical and mental health care at the clinics, including managing chronic conditions like diabetes and asthma, basic labs, X-rays and medications, and limited office-based behavioral health services. Patients may also qualify for discount prescription cards.
Already, Idaho’s 60 community health centers – including Heritage Health and Kaniksu Health Services in North Idaho – have expressed interest in becoming providers for the plan, along with 38 rural health centers. Any qualified provider willing to charge sliding-scale fees, track patients’ care and make reports to the state could participate.
