Many Low Income Idahoans Lack Qualification For State's New Health Insurance

By Steve Jackson

Idaho’s heath Insurance exchange is starting to pick up steam as more individuals are signing up for insurance under the Affordable Care Act, but there are still a large number of low income folks in the state who are not eligible for coverage.

The Idaho Health Exchange, called “Your Health Idaho” is starting to see more people signed up, after a slow start when the programs got underway in October. Amy Dowd is the Executive Director. She says "the most recent numbers we have are 1,730, but we do have almost 4,500 that were pending before the end of November.”

It’s believed there are 200,000 Idaho residents who have no health insurance. And more people could be eligible to sign up for coverage , except for one major problem. Idaho was one state that decided to not take option of accepting federal funding to expand their Medicaid rolls.

Currently there are about 245,000 enrolled in Medicaid, of which 70 percent are children. Getting on Medicaid is difficult in Idaho for adults, unless they are pregnant, have children, are disabled or elderly.
And they have to have extremely low income.

Tom Shanahan: "The current cut off for an adult to qualify for Medicaid is 20 percent of the federal poverty level, so if you took an adult with a child , so your talking an annual income of about 3 thousand dollars.”

Tom Shanahan of the Idaho Department of Health and Welfare says it’s estimated if Idaho had taken the federal funding to expand Medicaid, about 104 thousand more people would qualify. But he says the current situation has created a big group of people who don’t qualify for Medicaid, even though they are low income, and who also don’t qualify for the new health insurance offered through the Your Health Idaho plan, either.

Currently the Idaho health plan allows for subsidies to buy insurance if someone’s’ income falls between 100 and 400 percent of the poverty level. 

Shanahan: “But for someone who earns less than 100 percent of poverty , there not eligible for a subsidy because when they passed the law originally , Medicaid expansion was mandatory, but the supreme court eliminated that, so there’s sort of that doughnut hole now where people less than 100 percent of poverty don’t have any options now if their state doesn’t expand Medicaid.”

So, for that example of an adult with a child, they can not get subsidized insurance through the state health plan if they have an annual income of between about 3000 and 15 thousand dollars.
While Idaho has turned down the federal offer to take funding to expand Medicaid, they still have an option to do so.

One group that thinks that might be a good option is the state’s biggest business lobby. The Idaho Association of Commerce and Industry says the state would do well to accept the federal money, but should look into crafting a new type of system that would let those low income folks buy insurance on the private market.

Alex Labeau is President of the Association. He says "Medicaid recipients would receive premium assistance to buy private insurance, and in our view that’s probably better way to go, because you have private sector solution that’s usually more efficient, and people will take better care of themselves as a result of that.”

Labeau says his group has sent a letter to Idaho Governor Butch Otter to reconsider the federal assistance offer, and look into the idea of using that funding to help those on low income purchase private insurance.

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