Council Studying Medicaid But Complexity Of System May Delay Implementation

A governor’s Medicaid reform council expects to recommend more than 100 ways to cut waste, save money and add flexibility to the program that offers health care to Idaho’s poorest residents.

The result likely will mean cutbacks in “unnecessary” spending - reimbursement for travel to doctors offices, the end of some adult dental coverage - but allow more and better care for those who really need it, council members said Thursday.

But the complexity of revamping the health care portion of Idaho’s social services system - a program that now costs about $2.6 million a month in Kootenai County alone - could easily stretch the reform process out another 18 months.

“If welfare reform is the trunk, Medicaid reform is the rest of the elephant,” said Blake Hall, Idaho Falls delegate to the panel.

Panel members currently are traveling the state seeking input on their recommendations before submitting them to Gov. Phil Batt in December.

They range from mundane suggestions - provide all recipients a medical handbook and a create a telephone hotline - to massive overhauls.

They also call for requiring recipients to give up some rights in exchange for benefits. For example, the state would ask for a federal waiver allowing it to file liens against recipients at the time of eligibility. Single mothers on welfare would have to divulge the name and whereabouts of a child’s father before receiving benefits.

Other draft recommendations include:

Limit the number of visits that are covered.

Teach family members to care for disabled children rather than rely solely on private duty nurses.

Allow the state to prescribe over-the-counter medication if it’s cheaper but just as effective as prescription medicine.

Stair-step eligibility requirements so people who now earn just a few dollars too much to qualify may receive limited benefits.

Some of the most potentially controversial recommendations may not immediately even seem related to health care.

The council likely will recommend state laws banning people from riding in the open beds of pickup trucks. It also is expected to seek laws requiring helmets for motorcyclists, people in off-road vehicles, snowmobile riders and children on bicycles.

State Sen. Gordon Crow, R-Coeur d’Alene, who also is a council member, said the problem is if someone is uninsured and wrecks a motorcycle without wearing a helmet, the cost to the state can be astronomical. If the victim lives and is hospitalized for life, the government cost could reach $150,000 a year.

But even Crow acknowledged that such proposals will face bitter opposition in the Legislature. Crow said he hasn’t taken a position on those suggestions.

Batt will decide this winter whether to ask the Legislature to act in 1997 on the proposals or go back to the drawing board.

, DataTimes