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In the world of social programs, Medicaid is one of the hardest to understand. It’s something of a catch-all program for low-income people, covering broad and divergent needs. Included are healthy children and adults with eligible dependent children, people with disabilities or special health needs, and the elderly. Eligibility is income-based and it varies according the category of qualification for the program.During the state’s 2011 fiscal year, more than three quarters of the funding allocated to the Department of Health and Welfare’s budget went to Medicaid. The program received about $1.55 billion in federal and state funding, with 74 percent of those dollars coming from the federal government.Enrollment in Idaho’s Medicaid program has grown substantially in recent years. The average monthly Medicaid enrollment was fairly stable between 2006 and 2008. It grew by about 3.5 percent. But in the last three years, the program’s enrollment has grown nearly 21 percent. Ballooning from about 185,000 in 2008 to 228,897 in 2012.

A Republican Representative's Take On Health Care In Idaho

Ada County Statehouse Capitol Building House Chambers
Frankie Barnhill
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Boise State Public Radio

Last month, Idaho Governor Butch Otter proposed a plan to provide health care to the estimated 78,000 Idahoans who don’t qualify for either Medicaid or subsidized health insurance under Idaho’s health exchange. The Primary Care Access Program would've subsidized basic doctor visits for those people, but last week a legislative committee voted against using tobacco settlement money to partially fund the $30 million proposal.

Representative Fred Wood, who sponsored the bill and is chairman of the House Health and Welfare Committee, has called the current state of health care in Idaho "unfair and wrong." But he says the political will of lawmakers to pass health care for that “gap population” is uncertain.

“I’m not sure at this point in time if anything is going to come forward,” said Wood. “I don’t yet have a sense of where the collective will is there.”

Wood is a retired doctor from Burley and says his role as a physician and administrator has shaped his view on the need for health care a great deal.

“I understand the need for everyone to have the ability to have health care, whether rich or poor; it doesn’t make any difference because it truly impacts everybody’s life,” said Wood. “It tremendously impacts our economy and our ability to have good commerce to keep our people healthy.”

Wood is advocating for health care reform based on a model similar to Idaho House Bill 260, which passed in 2011. In that measure, lawmakers requested that the contractor and consumer assume all of the financial risk when it comes to health care. For Wood, the disconnect over health care policy in Idaho comes down to fairness. He says that while a doctor can’t refuse care at Idaho’s 65 Federally Qualified Health Centers, many people don’t seek preventive care because they can’t afford it. That, he says, is a factor as to why some Idahoans are dying early.

“As I said before the budget committee, I have the best health insurance policy in the state of Idaho and it’s provided at taxpayers’ expense,” said Wood. “I think it’s unjust and wrong that I have that and others don’t.”

As for the future of funding health coverage for the “gap population,” he said that people in every constituency that Idaho lawmakers represent want entirely different things. Wood said that those differing views make finding a solution that lawmakers can agree on is what makes progress so difficult. 

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