[Vision2020] Health Care Insurance (Lewistion Morning Tribune)

Ron Force rforce2003 at yahoo.com
Thu Mar 25 08:24:00 PDT 2010


Obama and Democrats did Idaho a favor
Marty Trillhaase

March 25, 2010

If Idaho Gov. C. L. (Butch) Otter and Republicans in the 
Legislature succeed in exempting Idaho from the just passed federal 
health reform package, who pays?
Who do you think covers unpaid medical bills now?
You do.
When someone incurs a medical debt he can't redeem within five 
years, he's considered a medically indigent person. Local county 
property taxpayers pick up the first $11,000 of the cost. A state-funded Catastrophic Health Care Fund pays the rest.
After ratcheting up steadily, the CAT program's costs this year 
have spiked. Blame the economy. As people lose their jobs and health 
insurance, they've turned to the CAT fund. It's not medical inflation so much - costs per individual are up 9 percent in four years - as it is 
sheer volume. 
The average monthly caseload jumped from 89 to 160 in the past 
four years. In 2006, CAT had 1,063 cases. It's already fielded 976 in 
the first six months of this fiscal year. It expects to process 1,500 
next year. 
In 2006, CAT's hit on the state budget totaled $22.8 million. 
It's already spent that much in the first six months of the current 
fiscal year.
The people administering the program believe after squeezing 
inefficiencies from it, they can bring expenses billed to the state down to $30 million annually. Add to that the local taxpayers' share at 
$16.5 million
By 2014, the program's costs will reach between $50 million and 
$70 million.
And then what?
National health care reform - the same bill just about every 
Idaho Republican in public office opposes - comes to the rescue. The 
Urban Institute estimates nearly 106,000 Idahoans will become eligible 
for Medicaid in 2014. Their kids already get it through the State 
Children's Health Insurance Program. But if an Idaho adult is 
able-bodied and earning any money at all, he can't.
Beginning in 2014, federal health care reform would allow someone earning $14,400 to qualify. A family of four could qualify if it earned $29,326.
Most if not all of the costs will be borne by the federal 
government. Federal subsidies will cover 100 percent of the costs 
through 2016. After that, the state's share will start at 5 percent and 
ease up to 10 percent by 2020.
A reasonable guess is the state's 10 percent share would come to 
$25 million. Even so, that's cheaper than 100 percent of CAT, which 
would be approaching $107 million by 2020.
Last year, House Democratic Leader John Rusche of Lewiston, who 
spent 15 years as a pediatrician, 13 years with Regence BlueShield and 
now serves on the board managing the CAT fund, estimated expanding 
Medicaid to working adults would reduce CAT's caseload by 80 percent.
Who's responsible for the rest of CAT's business?
Would you believe people with higher incomes and more resources 
who opt not to buy health insurance? And they tend to generate some of 
the larger claims against CAT.
Under national health care reform, those folks would be required 
to get health insurance. Some would qualify for subsidies to help defray the costs.
And don't forget: Each group would draw on the benefits of 
preventive care, rather than waiting for a crisis that sends them into 
the emergency rooms.
Sure sounds like President Obama and the Democratic Congress did 
Idaho taxpayers a favor on this one. If nothing else, health care reform ought to save enough CAT fund dollars to pay for the lawsuit Otter and 
lawmakers plan to wage to strike it down. - M.T.


      
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