Bill would extend primary care coverage to uninsured

Feb. 10--BOISE -- A bill introduced Thursday into the state Legislature would extend primary care coverage to 15,000 adults with chronic health conditions earning less than the poverty level.

The proposal, from Sen. Steven Thayn, R-Emmett, would cost an estimated $9.9 million in the first year and $15.6 million in the second.

The Community Primary Care Program would cover up to $600 a year worth of doctors' visits and a handful of medical procedures, and would also provide access to low-cost drugs. It would cover people who don't qualify for Medicare, Medicaid or subsidies to buy insurance on the state exchange and who have asthma, diabetes, heart disease, hypertension or are obese. The program would also promote life coaching for participants in the hopes of helping them out of poverty.

The bill fixed the reimbursements for some of the procedures it covers for the first year -- joint injections and thyriod testing, for example, would be $10 each, while skin lesion excision and biopsy and repairing lacerations would be $20 each. The board of the already existing state Catastrophic Health Care Fund would set the prices in subsequent years and would oversee the program.

The Senate Health and Welfare Committee voted unanimously to print the bill, clearing the way for a hearing.

Thayn's bill is the first major proposal to extend some coverage to the uninsured to be introduced this year. So far, the governor and Republican legislative leaders have mostly said they don't want to take any action on health care until they know what is going to happen in Washington, D.C., where both President Donald Trump and the Republicans who control Congress have said they want to repeal the Affordable Care Act.

Idaho politicians have been debating indigent health care ever since a U.S. Supreme Court ruling that said states had the option of whether or not to expand Medicaid coverage to the poor under the ACA. The Democrats have generally supported expansion, while the Republicans have mostly opposed it. If the ACA is repealed or substantially modified, however, Medicaid expansion might not be an option anymore.

Thayn's proposal bears some similarities to a proposal Gov. C.L. "Butch" Otter made last year to expand primary care coverage to the uninsured, although Thayn's is less expensive and is more limited in who would be covered. Otter's proposal died, and the session ended with the House and Senate deadlocked on whether and how to seek a federal Medicaid expansion waiver.

The Millennium Fund, an endowment that comes from a nationwide tobacco settlement in the 1990s, could cover the cost in the first year of Thayn's plan, but some general fund money might be needed in the second.

Editor's note: Thayn's last name was misspelled in an earlier version of this story.

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