Idaho avoiding simplest health-care fix

An Idaho legislative group is meeting to figure out how to extend health care coverage to residents in the “gap,” meaning they earn too much for Medicaid and too little to qualify for subsidies offered through the health care exchange established under the Affordable Care Act.

Approximately 78,000 Idahoans fall into the gap. Most of them have jobs, with high concentrations in the retail, restaurant and construction sectors.

Thirty-one states have solved the problem by accepting the federal government’s expansion of Medicaid. Idaho has chosen to make this more difficult by searching for a solution that would pass ideological muster. That is, legislators feel the need to say this is an Idaho solution, not a federal one promoted by a Democratic president.

Under Medicaid expansion, the government initially covers 100 percent of the cost of coverage for those in the gap, with the federal share eventually lowering to 90 percent. So at some point, the state would need to cover 10 percent of the cost.

But two state-commissioned health care reports have found the state would come out ahead if it dumped its county-funded indigent plans and joined the federal program. One report says these county plans need an extra $284 million over the next 10 years. But if the state expanded Medicaid, it could save $6.5 million instead. The Idaho Hospital Association projected $407.4 million in savings.

A recent study published in the journal JAMA Internal Medicine shows the immediate benefits for the newly insured. Researchers compared two states that accepted Medicaid expansion in 2104, Arkansas and Kentucky, with one that didn’t, Texas.

Unsurprisingly, the newly covered Arkansas and Kentucky residents were getting greater access to care and had fewer health-related financial struggles.

More patients were getting regular check-ups and more chronically ill patients were getting regular attention, the Los Angeles Times reported. Meanwhile, Texans in both categories were getting less care.

“In Arkansas and Kentucky, the share of poor adults without health insurance plummeted between 2013 and 2015, from more than 40 percent in both states to 14 percent in Arkansas and less than 9 percent in Kentucky. In Texas, by contrast, the uninsured rate dropped only from 39 percent to 32 percent,” the Los Angeles Times reported.

On Thursday, an emergency room doctor explained to Idaho legislators the financial conundrum uninsured patients face. He said 20 percent of the patients he sees per shift at Saint Alphonsus Hospital in Nampa are uninsured, the Idaho Statesman reported.

“We will see you, we’ll treat you, we’ll give you world-class care, but you know in the end it may financially ruin you,” said Dr. Darin Lee. “Patients are not oblivious to that.”

Thus, they wait until their conditions reach the crisis point before seeking care. Nobody benefits from this arrangement.

Idaho legislators should swallow their political pride, and do what’s best for the uninsured and for the state’s bottom line.