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Coeur d’Alene meetings to draw input on Idaho health reform proposal

A public comment session on the Idaho Health Care Plan waiver proposal drew an overflow crowd in Boise on Thursday, Dec. 7, 2017, as did a session Friday in Pocatello. Public comments next will be gathered in Coeur d’Alene. (Idaho Voices for Children)
A public comment session on the Idaho Health Care Plan waiver proposal drew an overflow crowd in Boise on Thursday, Dec. 7, 2017, as did a session Friday in Pocatello. Public comments next will be gathered in Coeur d’Alene. (Idaho Voices for Children)

Idaho’s latest plan to address the state’s health coverage gap will be addressed in two public sessions in Coeur d’Alene. An informational session on Monday from 5:30 to 6:30 p.m. at which people can hear presentations about the plan and get questions answered, and a formal public comment hearing on Tuesday morning.

The proposal, dubbed the Idaho Health Care Plan, calls for the state to seek waivers from the federal government to allow a portion of those who now fall into the state’s health coverage gap – because they make too much to qualify for Medicaid, but too little to qualify for subsidized health insurance through the state insurance exchange – to either get subsidies, or, for those who are the sickest due to certain specific conditions, such as stage 4 cancer or cystic fibrosis, Medicaid coverage.

Previous public sessions in Boise and Pocatello have drawn overflow crowds and strong support for the waiver plan. But many who’ve spoken also have called for expanding the waiver proposals to include serious mental illnesses along with other specified conditions. Though some earlier drafts of the proposal did include those, the current draft does not.

“This is the first time the public has had a chance to give us feedback about this,” said Health and Welfare spokesman Chris Smith. “This is us listening to the people of Idaho: What do they want? And then trying to take that and say, OK, what’s possible for us to do within the bounds that we have?”

“We’ve been really impressed with the turnout that we’ve had,” Smith said.

For the Idaho Health Care Plan to move forward, federal authorities would have to grant two waivers, one to the Department of Health and Welfare and one to the state Department of Insurance; and then the governor and Legislature would have to sign off on the program, including state law changes to authorize it.

Idaho lawmakers have declined to expand Medicaid under the Affordable Care Act, leaving an estimated 78,000 people in the coverage gap. Under the Idaho Health Care Plan, about 38,000 low-income, working Idahoans who now fall into the gap could receive federal tax credits to help them afford private insurance. The plan envisions that moving the sickest Idahoans off the exchange to Medicaid would also lower costs for all those purchasing plans through the exchange.

Among those who have offered public comments thus far are Jim Baugh, executive director of Disability Rights Idaho, who called during the Boise hearing for expanding the serious-illness waiver to include serious mental illness. He also called the proposal “a positive step.”

Jim Giuffre, former president and CEO of Healthwise and a former district health director for the state, said the plan would benefit patients, businesses, the state budget, and counties, which, he said, are “spending a disproportionate amount of their money on what is called the indigent fund, and it’s a ridiculous way to fund health care in the state of Idaho and it doesn’t do a very good job of it.”

The indigent fund pays the catastrophic medical bills of those who can’t afford to pay, drawing on local property taxes. But it doesn’t provide any coverage pre-catastrophe. Moving to something like the Idaho Health Care plan instead, Guiffre said, is “the right thing to do.”