Expanding Medicaid was the most prioritized and contentious topic of discussion at an informal meeting of Southeast Idaho physicians and state legislators in Pocatello last week.
That’s according to state legislators the Journal spoke with who attended the dinnertime event at Café Tuscano in Pocatello.
“The main topic was that they (physicians) would like to see Medicaid expanded,” said state Rep. Elaine Smith, D-Pocatello. “(Whether that happens) will depend on the majority leadership of the House. I would like to have a hearing on Medicaid expansion, but I don’t know at this point what will happen. I think we owe it to the Idaho citizens to have hearing. Whether it would pass from the House floor? It depends on who gets elected (in November).”
The doctors’ desire seems to echo the stand of the Idaho Medical Association, or IMA, which is also advocating the expansion of Medicaid.
The legislators the Journal spoke with after the meeting said they were provided a one-page pro-Medicaid expansion handout at the gathering prepared by IMA.
State Sen. John Tippets, R-Bennington, said the physicians attending the meeting favored what he called “Medicaid redesign.”
“It’s a situation quite unique,” is how Tippets described Idaho’s current Medicaid/Affordable Care Act situation.
The senator expressed some concern that state residents who are working and living below the poverty level are not eligible for federal subsidies to help them pay their health insurance.
“That needs to be addressed,” he said. “They are too poor to get help, and most legislators think that needs to be fixed.”
But Tippets stopped short of supporting any expansion of Medicaid. He said that IMA wants to expand Medicaid to those whose incomes are up to 133 percent of the poverty level, and he indicated that the percentage was way too high.
Currently under the federal Affordable Care Act in Idaho, those who make below the poverty level are not required to purchase health insurance, but if they choose to do so, must pay full price for it. And should a member of the working poor not covered under health insurance get sick or hurt, it is up to indigent health funds of each county to pick up the cost — that according to prior Journal reports.
Medicaid expansion was also among the topics of debate at the Oct. 9 gubernatorial debate between Idaho Gov. C.L. “Butch” Otter and Democratic challenger A.J. Balukoff. Balukoff called for expanding Medicaid, while Otter said he was concerned about the program remaining sustainable.
Dr. Brandon Mickelsen was the Pocatello physician who hosted last week’s informal gathering between doctors and legislators. There, he asked the Journal not to listen in on the discussion so doctors could be more open and candid with state legislators about their concerns, and the Journal complied. Michelson said these not-open-to-the-public meetings were held in doctors’ homes in past years.
State Sen. Roy Lacey, D-Pocatello, told the Journal: “It was a very nice meeting with lots of discussion on the topics, and we received at lot of information important to us in the Legislature. It was the best meeting we’ve had in several years.”
But Lacey said he was not willing to discuss any of the specifics discussed during the meeting.
“I don’t feel good about doing that,” he said “I don’t want to do anything to jeopardize the relationship we have with the medical association.”
Also attending last week’s gathering was state Rep. Kelley Packer, R-McCammon.
“The IMA shared with the legislators present their hot topics for the 2015 session, which included Medicaid design, SHIP, loan repayment enhancement to help recruit doctors to Idaho, teen tanning regulations, among other topics,” Packer said in an email. “Obviously, nothing was decided on, as this was simply a meeting to allow them (doctors) a chance to inform legislators on issues important to them.”
Smith, however, was able to elaborate more on the topics that were discussed at last week's meeting. For instance, the Pocatello Democrat described “SHIP,” or the Student Health Insurance Program, as a statewide health care innovation plan to redefine Idaho’s health care delivery system, and the doctors wanted to improve it. She added that the doctors presented legislators with a list of at least seven priorities they had for legislators in the 2015 session.
“They (the doctors) also talked about the residency program because we have a residency program at (Idaho State University), and the need for additional funding for that program,” Smith said.
Smith added that telemedicine was also discussed. She said although the doctors emphasized the inportance of face-to-face meetings with patients, they acknowledged a need for extending electronic doctor-patient communication, particularly for those living in the state’s rural areas.
“The Idaho Medical Association is developing statewide policies on this issue,” she related.
Tippets said the doctors also wanted the state to increase funding for WWAMI because they want to develop a medical school in Idaho, which currently does not have one. WWAMI is an acronym for a medical education program that serves Washington, Wyoming, Arizona, Montana and Idaho.
He added that the doctors wanted more funding for programs that pay the tuition of doctors relocating to Idaho to offset the shortage of physicians in the state.
The physicians attending last week's meeting also said they want to introduce a bill on indoor tanning restrictions for minors this session, but Smith said they gave no specific information on the issue.
A March 6, 2012, New York Times article on tanning salons in state says that “Idaho consistently has one of the highest rates of melanoma deaths in the country.”
The report also states that, “according to Idaho’s Youth Risk Behavior survey, 30 percent of high school girls had used a tanning bed in the previous 12 months (between 2011 and ’12),” and data showed that 4 percent of 11th-grade girls used tanning beds 40 or more times a year. Back then, the report states, Idaho public health officials cited statistics showing that people who start using tanning beds before age 30 are 75 percent more likely to develop melanoma, and that melanoma is among the most common cancers for women under 30.
Also attending last week’s meeting was state Sen. Jim Guthrie, R-McCammon. The Journal was unable to reach Guthrie for this story.
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