Bill to revamp indigent care, public health introduced

William L. Spence, Lewiston Tribune, Idaho
·4 min read

Mar. 10—BOISE — A major revamp of Idaho's indigent health care and public health system was introduced in the House Health and Welfare Committee on Tuesday.

The bill, sponsored by Rep. John Vander Woude, R-Nampa, saves Idaho counties an estimated $12 million per year by limiting eligibility for the indigent care system.

It also ends any state financial support for public health districts and shifts those costs to the counties. That would save the state an estimated $9.8 million per year and cost counties an equal amount.

The impetus for the bill dates back to 2018, when Idaho voters approved the expanded Medicaid initiative. It was anticipated that the program would cost the state about $40 million; however, it would also save counties millions of dollars by reducing the need for indigent care.

The indigent or catastrophic care program serves as the payer of last resort for people who can't otherwise afford medical treatment. Counties cover the first $11,000 of someone's bill, and the state picks up the remainder.

Ever since expanded Medicaid was enacted, lawmakers have talked about reducing the state cost by tapping some of the county savings. Vander Woude's bill accomplishes that by ending state support for public health districts and shifting the burden to the counties.

If the legislation is approved, people who qualify for Medicaid or for subsidized health insurance through the state exchange would no longer be eligible for the indigent care program. (That, at least, is the intent; the actual wording in the bill, though, only references people who qualify for Medicaid or who are "eligible for health insurance," without any mention of the state exchange.)

The idea is that people who are eligible for taxpayer-funded health care through Medicaid or the state health exchange should enroll in those programs, rather than waiting until they are sick and then seeking assistance through the more-costly indigent care system.

The measure includes an emergency clause, meaning the changes in indigent care eligibility would take effect as soon as it's signed into law.

The legislation hasn't been assigned a bill number yet. Nevertheless, given the rush to wrap up work as the end of the session approaches, House Health and Welfare Chairman Fred Wood, R-Burley, said he intends to hold a public hearing on the bill Thursday.

VICTORY FUND — Rep. Caroline Troy, R-Genesee, introduced legislation establishing a new "opioid settlement fund" to hold any money the state receives from ongoing lawsuits.

During a brief House Health and Welfare Committee hearing, Troy noted that Idaho is involved in multiple lawsuits against opioid manufacturers and distributors. The lawsuits seek to hold the companies accountable for alleged deceptive marketing practices that resulted in increased addiction rates and overdose deaths in Idaho.

Earlier this year, the state learned it will receive about $2.9 million through one lawsuit settlement.

"We need a place for that money to land," Troy said. "This (bill) establishes an opioid settlement fund and provides a way to use that money."

The legislation requires that the settlement funds be used for opioid abuse prevention and treatment programs. The state Behavioral Health Council would be responsible for recommending how the money should be spent, but the Legislature would have to authorize any appropriation.

TAKE A LOAD OFF — Idaho businesses will be able to subtract certain coronavirus relief funds from their 2020 taxable incomes, under legislation that earned a quick thumbs-up from the Senate Local Government and Taxation Committee.

House Bill 251 applies to the Rebound Idaho small-business grants, forgiven Paycheck Protection Program loans and Economic Injury Disaster loan funds.

However, it specifically excludes emergency rental assistance funds that went to landlords.

Rep. Dustin Manwaring, R-Pocatello, said rental assistance funds that went directly to tenants are already nontaxable. The dollars that went to landlords, by contrast, are considered replacement funds and remain taxable.

During a presentation to the joint budget committee earlier this year, Division of Financial Management Administrator Alex Adams noted that Idaho businesses received nearly $3 billion in coronavirus relief funds last year. That's roughly 50 percent more than the state currently receives in individual and corporate income tax annually.

No one testified on HB 251 in committee, and there was not discussion before the bill was sent to the Senate floor with a favorable recommendation. It previously passed the House on a 63-4 vote.

Spence covers politics for the Tribune. He may be contacted at bspence@lmtribune.com or (208) 791-9168.