2016 GIFCC Legislative Priorities
Provide Health Insurance Coverage to Idaho’s Gap Population
-------“Implement Medicaid expansion or an Idaho alternative to provide necessary health insurance coverage for approximately
77,000 Idahoans who are currently ineligible for both coverage under Medicaid and incentives to purchase coverage
through the Idaho Health Insurance Exchange.”
-------In Idaho, 78,000 residents fall in the health insurance coverage gap – the majority from working families. Idaho currently
has several options aimed at closing the gap on the table.
The first is the Primary Care Access Program (PCAP), introduced by Governor Otter. The PCAP provides a model of health
care based on the patient centered medical home that focuses on connecting program participants with an ongoing
healthcare provider who take responsibility for providing for a patient’s basic preventive, physical and mental health
needs, including: acute care for illnesses and injuries; coordination of patient care and management of chronic
conditions; and basic labs, x-rays, pharmacy, and limited office-based behavioral health services. Hospital stays,
emergency department use, or specialty care is not included, some of which will continue to be funded for the gap
population by Idaho’s taxpayers through the county medically indigent program and the State Catastrophic Health Cost
Payment program.
The second option is Medicaid expansion, which is the focus of Senate Bill 1204. This bill directs the Department of
Health and Welfare to change their definition of Medicaid eligibility to include all individuals whose income is below 138%
of the Federal Poverty level (FPL). This bill’s sponsor expects it: 1) to have a positive impact on the health and
productivity of our citizens by increasing access to health care; 2) to unburden our economy by reducing bankruptcies due
to uncovered medical expenses; and 3) reduce government by eliminating the need for county indigent programs and the
State Catastrophic Health Cost Payment program.
The third option, Senate Bill 1205, would make people earning less than 100% of the Federal Poverty Level (FPL) eligible
for Managed Medicaid enrollment, which is the concept of the Healthy Idaho Plan that was developed by Governor
Otter’s Workgroup on Medicaid Expansion. This legislation would provide for Idahoans earning between 100% - 138% of
FPL to be enrolled in the state exchange and their premium supported by state and federal funds. This bill’s sponsor
believes there would be many broad social and economic impacts to providing health insurance and removing the threat
of medical bankruptcies from the working poor in Idaho.
As a Chamber, we applaud Governor Otter’s commitment to the gap population by introducing the PCAP, an Idaho plan
for Idahoans. However, this plan needs to go further to provide comprehensive health care for individuals in the gap. The
Healthy Idaho Plan is also an Idaho-specific plan which provides full insurance coverage to those in the gap. However, any
of these three options would provide more health care coverage to those Idahoans who fall in the coverage gap than they
have today.
Greater Idaho Falls Chamber of Commerce
425 N. Capital • Idaho Falls, Idaho 83402
[email protected]