Idaho legislative panel calls for closing health coverage gap, but no agreement on how

BOISE – A legislative working group that held months of meetings and hearings voted unanimously Tuesday to call for the Idaho Legislature to take action next year to address the state’s health coverage gap.

However, the 10-member panel was vague on exactly how the state should close the gap, which includes 78,000 uninsured Idahoans unable to access health insurance because they make too much to qualify for Medicaid but too little to qualify for subsidized coverage through the state’s insurance exchange.

“A policy to provide health care of some kind to the gap population should be enacted by the 2017 Legislature,” said the committee’s final report to the full Legislature.

The panel debated including more specific recommendations but decided against it.

“We have said that there is a problem and it needs to be solved, and the ’17 Legislature ought to solve it,” said Rep. Fred Wood, R-Burley. “I think that if we try to prescribe any solution whatsoever, then those that are opposed to that will immediately reject the findings of the committee.”

Rep. Tom Loertscher, R-Iona, co-chairman of the panel, said lawmakers have neglected the issue too long. Idaho has been debating for four years whether to expand its Medicaid program, largely at federal expense, under the national Affordable Care Act. Now it’s uncertain if that will even be an option for the state.

“We can’t ignore this, we’ve got to find a solution,” said Sen. Marv Hagedorn, R-Meridian, the panel’s Senate co-chair. “And now it’s up to all of us, individually or in teams, to come up with some legislation that will solve this problem.”

The panel’s final report recommends that if Idaho expands Medicaid in any way, the legislation should include a sunset clause saying it can be undone if federal policy changes. It also calls for including a focus on primary and preventive care, and shifting all those on Medicaid in Idaho to managed care; that’s a move that’s already being phased in.

The report also recommends that the state tap its Millennium Fund, an endowment that Idaho created with proceeds from a national tobacco settlement, and the state general fund to pay for any state expenses associated with closing the coverage gap. Millennium Fund earnings each year go largely to health-related programs, including tobacco cessation and drug and alcohol abuse prevention. This year’s distributions are $9.6 million.

Since July, the panel has received 515 public comments, of which 426 “favored some kind of health care coverage for the gap population,” said legislative analyst Elizabeth Bowen. “Seventy-six were opposed.”