Otter’s proposed health plan finds weak support

Business advocates and health professionals say the Idaho governor’s health plan is a nice start, but it doesn’t go far enough.

Gov. C.L. “Butch” Otter announced a plan Jan. 7 to help 78,000 uninsured Idahoans receive basic healthcare services. These uninsured people earn too much to qualify for Medicaid, but don’t earn enough to qualify for tax credit supplements for health insurance.

The plan would pay health providers $32 a month per patient to provide primary care. The services are primarily preventative, however, and the plan does not cover the costs of prescriptions, hospitalization, emergency transportation or specialty care. It doesn’t go far enough to provide the care that people in Idaho need, said House Assistant Minority Leader Mat Erpelding, D-Boise.

“In essence, the plan provides a few doctor visits, but does not support services most likely to cause severe financial hardship,” Erpelding said.

In his State of the State Address Jan. 7, Otter said Health and Welfare Director Dick Armstrong worked for years to form the proposal to help Idaho’s working uninsured while not expanding Medicaid through the Affordable Care Act with the use of federal funding.

Many uninsured Idahoans don’t seek medical attention until they are sent to the emergency room, which is the most expensive care option. Business and policy leaders, including the Idaho Association of Commerce and Industry, the state’s largest business lobbying group, have called on the Legislature to expand Medicaid, saying that doing so would save the state money by preventing those emergency room visits and the use of other emergency measures. The Boise Metro Chamber of Commerce has also been advocating for Medicaid expansion for years.

“Besides this being the right thing to do, if everyone’s costs are maintained it will keep healthcare costs for everyone else down,” Connors said.

Otter’s proposal aims to lower the number of expensive visits by encouraging more frequent checkups and preventative measures.

“This project to provide basic primary care by assigning them to a clinic will help with many of their problems,” Department of Health and Welfare Director Dick Armstrong said. “Many have chronic diseases without any way to manage them.”

The program would cost the state about $30 million. The money would come from tobacco and cigarette taxes and the programs that now use that funding would be moved to the General Fund, Otter said.

The plan would also have a major effect on health clinics. Many clinics around the state would have to add more staff and hours of operation to serve the additional 78,000 patients. Kootenai Health CEO John Ness estimated that about 400 additional physicians would be required to address the influx.

“There are about 1,200 physicians and I’m just doing the math on the spot, but my rough calculation is each would have to take on about 130 patients,” Ness said. “It would seem adding 200, 300 or 400 doctors isn’t much, but it is a huge undertaking.”

The governor’s office said the numbers would not be as drastic as Ness calculated because the estimate of 78,000 patients is a worst-case scenario. Also, not everyone will enroll, and many uninsured workers are already on clinic workloads, said Otter’s office.

“Some reports we’re hearing is that we don’t have the physicians to do this,” Otter said. “We figured for the largest possible amount at $32 to the clinic per patient per month, but if there are less we can recalculate. Young people aren’t going to sign up for this. We have already seen that through the healthcare exchange.”

Dr. Ted Epperly, CEO of Family Medicine Residency of Idaho, was at the Statehouse January 11 to advocate for Close the Gap Idaho, which has proposed its own plan. Close the Gap Idaho is a coalition of more than 120 organizations including the Idaho Hospital Association.

“Let me start by saying I am pleased that the governor is stepping forward on this,” Epperly said. “This is a step in the right direction, but by no stretch of the imagination all of what needs to be done.”

Close the Gap Idaho said Otter’s Primary Care Access Program wouldn’t help enrollees manage significant ailments such as diabetes or cancer.

“As a doctor I will look at a patient and see what is going on, but I need to know I have viable options to treat them,” Epperly said.