House passes Medicaid exclusion on indigent fund

The Idaho House took a turn Monday in its ongoing dance with Medicaid, as a bill that would exclude Medicaid-eligible Idahoans from claiming indigent status abruptly skipped the line and passed after only a second reading.

House Bill 316 passed the Health and Welfare Committee on Thursday but was only up for its second of three readings Monday morning. Majority leader Mike Moyle suspended the rules and took up the bill for a vote.

HB 316 requires that all Idaho adults eligible for Medicaid would be ineligible for the state indigent health care program, which serves the poorest of Idahoans and essentially writes off the patient’s financial responsibility — the first $11,000 of health care costs are charged to the county, while the remainder is charged to the state.

“The intent of this legislation is, if you qualify for Medicaid, or if you qualify for insurance, you no longer qualify for the indigency fund or the (catastrophic) fund,” Rep. John Vander Woude, R-Nampa and sponsor of the bill, said Monday. “This will tighten up the eligibility.”

The move came the same day a study was released that depicts Idaho’s Medicaid coverage as sharply behind the national average.

Internet marketing company WalletHub released the study, which measured the level of each state’s Medicaid coverage. The study weighed 12 factors from each state, including per capita Medicaid-eligible population, the outcome of patient care, and the state’s spending toward Medicaid.

According to the study, Idaho ranked in the bottom 10, coming in at 41 out of 50.

While Idaho actually fared well in per capita enrollment — 15th out of 50 nationwide — the quality of that care ranked second-to-last, besting only Georgia.

Among the factors bottoming out the Gem State are mental health follow-up appointments and child wellness visits, according to data from the Centers for Medicare and Medicaid Services.

HB 316 also directs funding of public health districts into counties’ hands. If passed, the bill would eventually save the state about $12 million per year, Vander Woude said. But opponents of the bill — including Rep. Ilana Rubel, D-Boise and assistant minority leader in the House — said HB 316 will put an unfair burden on hospitals, which are required under federal law to treat anyone seeking service.

“I do think it’s important everybody understands who is being stuck with the bill here,” Rubel said. “I think it’s actually not going to be the people getting the services so much as the hospitals left holding the bag here.”

HB 316 now goes to the Senate for consideration.