Nearly 150 children, already qualified for new subsidized medical care targeted at poor but working families, were disqualified on Wednesday by legislative budget writers.
The action was the latest in what may be a continuing political turf war with Gov. Phil Batt’s administration over the program Batt began last fall with savings from welfare reform.
The Joint Finance-Appropriations Committee voted to limit eligibility for the expanded health care to children of families whose incomes are 150 percent of the poverty level.
When it started the child health care program on Oct. 1, the Batt administration set the income eligibility ceiling at 160 percent of the poverty level under a federal plan intended to bring uninsured children into the health system by giving states 78 percent of the money needed to pay the bills.
More than 1,040 children had qualified under that guideline. The lower ceiling throws 148 of them out. And even under the administration’s very optimistic utilization estimates, it leaves unspent more than $3.6 million of Idaho’s authorized share of federal money and $900,000 of the already approved $4.2 million in state matching funds.
“Why in the world would we want to take 148 current cases off and leave $3.6 million in federal money unspent?” Democratic Sen. Marguerite McLaughlin of Orofino asked.
Republican Sen. Dean Cameron of Rupert reflected the concern of a number of committee members that despite caps on the federal and state commitments to the program, demand could far exceed the allotted cash. That would force the state either to pump more general tax money into the program or deny coverage to even more children in the future.
“It will be much more difficult down the road if we have too many kids trying to access this program,” he said.
But Cameron also said the 150 percent eligibility ceiling may well have been the only alternative to an even lower one being pushed by a solid bloc of the 20-member committee.
A year from now, he and others said, the situation can be reevaluated and eligibility guidelines adopted that assure maximum use of the available cash without a threat that demand for care will exceed it.
The political crossfire that seems to be victimizing children began last week when the committee voted to end, at least temporarily, the state’s participation in the Child Health Insurance Program. The program, for at least five years and likely 10, will provide the state with nearly $16 million a year in federal money if it puts up $4.2 million of its own.
The majority wanted to suspend the program until a full assessment is made on the most efficient method of using the combined $20 million. Batt planned that this spring anyway.
That vote came after a number of budget writers complained that the governor authorized the program without getting their approval first.
Batt moved quickly last fall to take full advantage of the earmarked federal money. Using it to treat children whose families are not poor enough to qualify for Medicaid, advocates argued, could work to limit the burden on county property taxpayers, who now cover the cost of health care for the poor not on government programs.
Batt called in legislative leaders to underscore the importance of the program and had top Health and Welfare Department officials meet with them for two days to iron out any misunderstandings.
But it apparently was not enough to preclude the driving desire of conservatives to put a secure lid on the cost to the state.
The administration had expected that once word of the program’s availability spread, it would eventually serve about 12,000 children a year under its original eligibility guideline.
The reduction in the eligibility made by the budget committee will reduce that number to about 10,400.
On the key vote, the administration was supported by McLaughlin, Democratic Sen. Bruce Sweeney of Lewiston and Democratic Rep. Ken Robison of Boise and Republican Sens. John Hansen of Idaho Falls and Cecil Ingram of Boise and GOP Rep. Hod Pomeroy of Boise.
Backing a lower limit in addition to Cameron were Republican Sens. Atwell Parry of Melba, Jerry Thorne of Nampa and Stan Hawkins of Ucon and GOP Reps. Bob Geddes of Preston, Maxine Bell of Jerome, JoAn Wood of Rigby, Ron Black of Twin Falls, Frances Field of Grand View, Dan Mader of Genesee, Jack Barraclough of Idaho Falls and Don Pischner of Coeur d’Alene.
Republican Sens. Mel Richardson of Idaho Falls and Evan Frasure of Pocatello did not vote.