With a legislative interim committee set to gather this summer to examine solutions for Idaho’s health insurance coverage gap – in which 78,000 mostly working Idahoans make too little to qualify for subsidized coverage through the state insurance exchange, but too much to qualify for the state’s very limited Medicaid program – the Idaho Statesman over the weekend did some myth-busting, examining “eight myths about covering the uninsured in Idaho.”
Reporter Bill Dentzer took on these myths:
1 – “We can’t afford it.” Actually, the current, highly inefficient system costs more than would expanding Medicaid in Idaho, he writes.
2 – “Medicaid is broken and Idaho shouldn’t expand it.” Actually, Medicaid premiums have grown slower than commercial rates – 5 to 10 percent slower since 2011. And since 2014, Idaho has been reinventing its health care delivery system for Medicaid, with the help of a four-year federal grant, to move away from the traditional fee-for-service model to a patient-centered medical home model, aimed at delivering better care at lower cost.
3 – “The gap population is made up of able-bodied adults who should be working.” Actually, they are. Two-thirds of the gap population is employed. About 12 percent have income from Social Security, child support or a pension. However, all have income that’s less than 100 percent of the federal poverty level.
4 – “Where did this 78,000 figure come from, anyway?” Extensive studies by Milliman, an actuarial firm working for the state, determined the figure, based on census and demographic data. The latest update, in January 2016, put the figure at 78,581.
5 – “It’s not an issue where I live.” Actually, there are people in the “gap” in all of Idaho’s 44 counties. The largest gap populations are found in Ada, Canyon and Kootenai counties.
6 – “The gap population has access to health care already.” People in poverty typically seek care only when they are seriously ill or injured, accessing it through emergency rooms – the most expensive way.
7 – “These are long-term welfare recipients.” Actually, Idaho’s TANF, or temporary assistance to needy families, welfare program has a lifetime limit of 24 months and requires its recipients to participate in work and training; a family of four with household income of $469 or more makes too much to qualify. People on food stamps in Idaho receive them for an average of 13 months.
8 – “Idaho doesn’t have enough doctors.” Dentzer quotes Susie Pouliot, CEO of the Idaho Medical Association, who says that’s no reason to deny health care. “Yes, there will be an initial surge of people seeking access because they have had unmet health care needs for a long time,” she said, “but that evens out over time.”
Dentzer’s full report is online here; it includes maps showing Idaho's gap population by county.