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Costs for patients on rise

County and state government budgets are barely keeping pace with the number of uninsured residents who need help paying their medical bills.

The caseload of the uninsured handled by the Kootenai County Assistance Office increased from 523 clients last year to 610 this year, according to Marla Lewis, manager of the county’s indigent fund.

Fortunately, Lewis said, the county has collected more in repayments, which is how the assistance office is able to cover its bills through this fiscal year, which ends Sept. 30.

“We spent it all,” Lewis said. “There’s so many uninsured people out there. Insurance is pretty spendy for the average person with a part-time or temporary job.”

Her office requested the commissioners increase the indigent budget by $624,000, but the proposed county budget calls for a $200,000 increase, to $1.6 million, as of Tuesday night’s budget hearing, according to David McDowell, county finance director.

Although it’s not as much as Lewis wanted, McDowell noted that an increase of almost 14 percent is more than most departments are getting.

When hospital patients are indigent, and can’t pay medical bills, Kootenai Medical Center refers them to county assistance. If they qualify for county assistance, the county pays up to $10,000 of their medical bills, and the state catastrophic fund covers the rest.

In response to the growing need, the Legislature approved a $3 million increase in the state catastrophic fund. Last year’s $12.1 million appropriation ran out before the end of the fiscal year, forcing the state’s fund manager to ask for a supplemental appropriation.

And in response to local government lobbying, the Legislature tightened the criteria for qualifying for county assistance. Now, patients have to show they cannot pay their medical bills within five years. Previously, the requirement was three years.

Despite ever-growing appropriations to help cover indigent costs, KMC still has to write off millions for charity and indigent care – about $21 million last year, said hospital CEO Joe Morris.

This year, he estimates, those unpaid bills will increase by 10 percent. To offset the increasing indigent costs, the hospital has to charge more to those patients who do pay.

“It’s not fair to the hospital or patients that we cover all our indigent or uninsured costs by raising their costs,” he said.

Among Idaho residents without health insurance, “80 percent are working, they’re just not covered by their employers,” Morris said. “Every year we see a rising number of uninsured. … We have to find some way for employers to cover employees.”

Private industry in Idaho is responding with some new, less-expensive options for employers. Regence Blue Shield of Idaho, for instance, is offering lower-cost coverage options for chamber of commerce members.

And Blue Cross of Idaho is working on a plan for businesses that have not been able to provide health insurance to employees for at least two years, said Jonathan Coe, executive director of the Coeur d’Alene Chamber of Commerce. Spearheading the push for more affordable insurance for employers was the Boise Chamber of Commerce, he said.

“The cost of providing insurance for employees is so expensive, that insurance providers are trying to find ways to be as creative as possible to get more people covered,” Coe said. If something isn’t done to expand medical coverage, he said, “the burden falls back on all of us” to pay the costs.