By TOM FAULKNER
and WENDY JAQUET
Wendy’s 67-year-old sister, Sally, was fixing her roses and fell off a ladder two weeks ago, breaking her right wrist, banging up her legs and cracking several ribs. After a visit to the emergency room, two doctor visits and 1.5 hours of surgery, she will recover, but at a cost of approximately $30,000. Fortunately, Sally has Medicare and a supplement, but what if this happened to one of the 70,000 Idahoans who fall into an insurance coverage gap?
Who falls into the coverage gap? Eighty-six percent of the 70,000 uninsured Idahoans are from working families who make too much to qualify for traditional Medicaid. These working families also make too little to qualify for tax credits in the Your Health Idaho insurance exchange. They are left with no affordable coverage option, while families with higher incomes get help.
In Idaho, the top four occupations of those who fall into this gap are food service workers; office and administrative support; construction; and farming, fishing and forestry. Idaho also has 10,000 uninsured veterans, many of which fall into the coverage gap. These Idahoans are our family members, our friends and our neighbors who are working hard, but have no financial protection from medical emergencies and little access to preventive care. It is even estimated that providing a coverage option to these folks could save around 100 lives each year.
How can closing the coverage gap save Idaho money?
Uninsured Idahoans often can’t afford preventive care and end up in the emergency room when a crisis occurs. When the time comes for them to pay the bill, they are unable to, which means they may declare bankruptcy. But closer to home for all of the insured is the fact that insurance rates are pushed up to cover these situations, hospital charges accelerate, and hospitals go to our county indigent-care system for help covering these bills. Millions of our state and local tax dollars go into this system each year and the costs are growing rapidly.
We support closing the coverage gap because it makes common sense. We can take advantage of federal dollars to implement the Healthy Idaho Plan, a solution designed by Gov. Butch Otter’s Medicaid Redesign Workgroup, which brings personal responsibility into our health care system and gives families in the coverage gap an affordable health care option. We know that federal cost-sharing to cover these Idahoans will save Idaho $184 million dollars over a 10-year period. This will get the counties out of the businesses of paying medical bills, therefore taking stress off our taxes. The economic boost will have ripple effects across our state, creating nearly 15,000 new jobs.
Right now, Idahoans are paying for these uninsured individuals through increased premiums because the uncompensated care by providers is being passed on to the rest of us on our insurance bills. Our property and state taxes, 100 percent Idaho money, are covering the uninsured who fall into this gap. Meanwhile, our federal taxes are going to states that have provided a Medicaid expansion instead of coming here to Idaho. Finally, those health professionals that are in Idaho may find it more attractive to move to an adjoining state that is competitive in offering affordable coverage options to its citizens.
If you would like to see our state enact a common-sense policy that saves money and improves our health and well-being, we urge you to visit with the legislative candidates in your community and ask them to commit to vote to close the coverage gap when this legislative session begins in January.
Tom Faulkner is a Gooding County commissioner and a member of the Idaho Workgroup on Medicaid Expansion. Wendy Jaquet is a former state representative for Blaine, Camas, Gooding and Lincoln counties.