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Boise State Public Radio News is here to keep you current on the news surrounding COVID-19, the disease caused by the novel coronavirus.

Dr. Ted Epperly On Role Of ACA During Pandemic And How Idaho Is 'Moving In The Wrong Direction'

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Dr. Ted Epperly, President and CEO of the Family Medicine Residency of Idaho, knows quite a bit about the Affordable Care Act. In fact, he was very much a part of its foundation in 2009, when he served as President of the American Academy of Family Physicians. More than a decade later, Epperly says the ACA is more important than ever, considering the nation is grip of a pandemic.

Eppery visited with Morning Edition host George Prentice to talk about the latest effort by opponents to dismantle the ACA, his current role as a commissioner on the Central District Health Board and why Idaho is moving in the wrong direction when it comes to curbing COVID-19.

“It's only going to get worse through the holidays … New Year's and Christmas. Weather is colder. People are inside. Holidays are happening. If we do not get on top of this now, come late December, come January, come February, before the vaccine is out, we're going to have numbers that may be double or triple what we're seeing now.”

Read the full transcript below:

GEORGE PRENTICE: It's Morning Edition on Boise State Public Radio News; good morning. I'm George Prentice. The Affordable Care Act is back in the news - it's in the news quite often. Most recently, we have listened to arguments before the U.S. Supreme Court as opponents once more try to dismantle the ACA. We're going to talk to someone who knows quite a bit about the Affordable Care Act, and that is Dr. Ted Epperly, President and CEO of the Family Medical Residency of Idaho. And Dr. Epperly knows so much about the ACA because, quite simply, he was there helping to forge what would become the Affordable Care Act. It's tough to fathom that it was a decade ago that I was talking with you in Washington, D.C. when you were meeting regularly with folks at the Obama White House.

DR. TED EPPERLY: That's right, George. During the time that I was the President of the American Academy of Family Physicians, which represents all 135,000 family doctors across the United States. I met and testified to Congress 18 times and talked with President Obama and his administration on six occasions about the Affordable Care Act and its creation. It has become absolutely critical at a time, like now with the pandemic, that we've expanded coverage to so many people. The Affordable Care Act took us from 50 million uninsured people to about 27 million uninsured. In other words, 23 million people got health care coverage at a time that it was really important to do so, despite all of the political wrangling around the Affordable Care Act. It's still foundational to better health care in this country.

PRENTICE: In time, it has never been more popular with Americans, across all political divides.

EPPERLY: That's exactly right, George. I think people have gotten used to it now: protecting preexisting conditions, allowing kids to continue on their parents’ plans up to the age of 26, making sure that there are caps on annual and lifetime insurance premiums. There was a ton of stuff in the Affordable Care Act that actually have become foundational to better health and better healthcare in the United States.

PRENTICE: Let's talk about COVID-19. You are a commissioner on the Central District Health Board. I'll make this very blunt: Is Idaho moving in the wrong direction?

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Credit Family Medicine Residency of Idaho
Dr. Ted Epperly

EPPERLY: Boy, that's a tough question, George, I think to simplify it, I would say that we are moving in the wrong direction at a time that we need to probably gear up more around mask mandates… I would say we need [a mandate] to be statewide, we need to make sure that we continue social isolation and distancing. I think we've learned a lot about how to live with the pandemic. But what we need to do a better job at is making sure that we take the masking and distancing seriously. There's no reason, I believe, to shut down the economy again. But if we could have everybody mask and distance, pay better attention to good hand sanitation, then I think we could all learn to live with this in a safer way, George. So, the lack of a statewide mandate on masking, or for other counties and health districts not to take up masking, that is moving in the wrong direction at a time that the pandemic is at its worst.

PRENTICE: What can a district health board do, as opposed to a municipality or a school board? Do you make recommendations?  Or can you supersede counties, cities or school boards?

EPPERLY: Yeah, that's a great question. Typically, the health districts want to work as collaborative partners with entities in their jurisdictions. In our case, the four-county area of Ada, Elmore, Valley and Boise counties, we want to work with people. In the example of school districts, the State Board of Education made it clear that they wanted jurisdictional authority by the school districts to make the final call; and we would give them data. So, in our role with schools, we make recommendations. I would just remind the community that for us to be in the Red Zone for schools, that's 20 cases per hundred thousand. But we're now at 80 cases per hundred thousand. We're 400 percent higher in terms of case counts above that minimum threshold. So that's why the Central District Health Board made a strong advisory recommendation to the community just recently about activities. We do have the authority to close down things. You saw this when we moved back to a Stage 3 earlier in the year. We closed down bars and nightclubs that we knew had known cases, from tracking. And so, we do have the authority to close down things if there are known violations. So, it does have the authority to supersede, and set advisories. The approach that we would like to take is collaborative. Let's advise. Let's work together. Let's make, as partners, better outcomes. But in the absence of those happening or in the absence of enforcement, then the Central District Health Department can make orders that would be binding. Of course, the question then is: Who enforces that? The public health department isn't an enforcement agency. So, we've got to have cooperation on the part of public law enforcement to carry out those orders, if indeed.

PRENTICE: And indeed, we have seen such action in the City of Boise. The mayor recently said, “Yes, we're in a position to enforce.”

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Credit Family Medicine Residency of Idaho

EPPERLY: Absolutely. And quite frankly, I applaud that decision. Why? Because this is serious. I contend, as a physician of forty-four years of practice, that we still haven't taken this virus as seriously as we need to, because we haven't been sick enough yet as a public. That's changing… more and more cases, record high cases, record high numbers of deaths, record high numbers of hospitalizations and ICU admissions. We are going to get sicker as a community. And so, I absolutely support what the mayor did, in terms of taking further steps now to try to turn this off. It's only going to get worse through the holidays…New Year's and Christmas. Weather is colder. People are inside. Holidays are happening. If we do not get on top of this now, come late December, come January, come February, before the vaccine is out, we're going to have numbers that may be double or triple what we're seeing now.

PRENTICE: He is Dr. Ted Epperly, President and CEO of the Family Residency of Idaho.  Dr. Epperly, as always, thank you so much. Take care.

EPPERLY: Hey, listen, I've got something for you: Stay positive and test negative, George.

Find reporter George Prentice on Twitter @georgepren

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