Writings and observations

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When Senate President Pro-Tem Brent Hill, R-Rexburg, said last week, “It’s not lost on us that we’re dealing with people’s lives here,” he was saying something that needed to be said . . . in that, a lot of Idahoans probably do think concerns about their health care have been lost on the legislators. Or at least on many of them.

When the Idaho Legislature has in recent years discussed establishing a health insurance exchange, something many other states have, the debate has tended to center on a discussion of just how evil the federal government is. The health of Idahoans wasn’t a factor, at least in their debate. Sometimes didn’t come up at all.

Lawmakers will get another chance to consider all this beginning Monday, when the legislature returns to town and starts to review a proposal on health care from Governor C.L. “Butch” Otter.

Otter has asked committees to look into the subject of expanding Medicare in Idaho as many other states have, and from those panels has gotten back responses in the affirmative. Actually following through remains politically problematic, mainly because the Idaho Legislature has given no indication it wants to go there. Evidently by way of trying to do something that might win legislative support (and it may), Otter proposed last week a $30 million program intended to address the medical needs of the 78,000 or so Idahoans who have no affordable health coverage.

The plan would cover enrollment at a clinic near where people live, and patients there could get an assessment and a plan for meeting their health needs, and maybe a prescription discount. Those are not bad things, and could help some people’s health and maybe reduce emergency room use. But actual substantial medical care, meaning more significant (or expensive) care such as hospitalization, the core of what an expanded Medicaid would provide and the kind of issues that have ruined many lives financially and otherwise, would not be covered.

Idahoans would get a health service some of them don’t have now. But the proposal drew a quick response from a large group of health care providers which pointed out its severe limitations.

Neva Santos, Executive Director, Idaho Academy of Family Physicians, said, “While investing in primary care is useful, as offered by PCAP, it will not provide the needed diagnostic or treatment options to maximally keep patients out of the emergency room or from costly hospitalization.”

Senate Minority Leader Michelle Stennett: “We’re still paying into the Medicaid expansion program we don’t receive any benefit from, so the dollars go to other states. We’re still taking care of CAT fund and indigent funds in our counties and cities, and now we’re being asked as taxpayers to pay $30 million for a new program.”

Expanding Medicaid would, by some estimates, save state taxpayers $173 million over the next decade.

Hill acknowledged that Otter’s proposal wouldn’t cover near what Medicaid would, but “There are other states that are looking at other alternatives that we may learn from, that we may be able to emulate somewhere down the road. We’ve gone 100 years without providing this service, we want to do it right. And this seems like a good step.”

He and Health & Welfare Director Richard Armstrong pointed out too that enacting this program wouldn’t mean Idaho couldn’t do more – such as a Medicaid expansion – later. And that’s true.

But it’s not hard to image future legislators saying, “We already took care of that,” whenever is raised the subject of actual serious medical coverage for the 78,000.

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Idaho Idaho column Stapilus