{"id":991,"date":"2019-03-12T20:15:12","date_gmt":"2019-03-13T03:15:12","guid":{"rendered":"http:\/\/danschmidtforsenate.com\/blog\/?p=991"},"modified":"2019-03-12T20:15:12","modified_gmt":"2019-03-13T03:15:12","slug":"brads-right","status":"publish","type":"post","link":"https:\/\/danschmidtforsenate.com\/blog\/?p=991","title":{"rendered":"Brad’s Right"},"content":{"rendered":"\n
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While the legislature struggles with modifying Medicaid Expansion, costing more, getting less insured, Governor Brad Little on the campaign trail was beating a different drum. He was looking beyond the twisted shorts condition of legislative Republicans who fought Proposition 2; he can see the bigger picture. Health insurance for those beyond Idaho\u2019s exchange, Your Health Idaho, are getting squeezed out of health care insurance. <\/p>\n\n\n\n

To be eligible for participation in the exchange you have to\nmake between 100%-400% of the federal poverty level. Medicaid expansion\naddresses those below 138% FPL. <\/p>\n\n\n\n

If you are a 60-year-old and you can participate on the YHI\nexchange and you make $45K per year, you might only have to pay 3% of your\nincome for health insurance since you get subsidies. But if you make more than\nthe 400% upper limit to participate in YHI, say up to $50K, you wouldn\u2019t be\neligible for exchange subsidies and the cost might jump to 32% of your income.\nThis is called the health insurance \u201csubsidy cliff\u201d. Many Idahoans are standing\non it. That\u2019s me folks. And it\u2019s steep. Why would I pay a fifth to a third of\nmy income for something I might not use? I\u2019d be a fool. Most Idahoans aren\u2019t. <\/p>\n\n\n\n

\"\"
This is from the Kaiser Family Foundation<\/a> . Idaho’s numbers are a bit different, but the cliff’s as steep.<\/figcaption><\/figure>\n\n\n\n

This is where the growing numbers for Idaho\u2019s Catastrophic\nHealth Plan are coming from. There is \u201cthe gap\u201d population, the 70,000 below\nthe 100% limit for enrollment on YHI, who will now be covered by expanded\nMedicaid; they won\u2019t be the uninsured anymore. But those above 400% are going\nto or have dropped health insurance because they aren\u2019t fools. Brad pointed\nthis out whenever he could. I didn\u2019t hear his solution.<\/p>\n\n\n\n

The trouble with Idaho\u2019s indigent program is, we take your\nassets if you can\u2019t pay your medical bills. The really low-income folks, those\nbelow 100% often had few assets. But I imagine those making $50K have some\ntools, a work truck, maybe a back hoe the county can file a lien on. There goes\ntheir health and their means of income if they get unlucky and sick. Welcome to\nIdaho and medical bankruptcy.<\/p>\n\n\n\n

So, beyond Bernie\u2019s \u201cMedicare for All\u201d, what can Idaho do\nabout this? It\u2019s a head scratcher. Brad keeps talking about the Idaho High Risk\nPool model and it\u2019s worth consideration. The HRP was developed 20 years ago by\nState Senator Dean Cameron (now Director of the Department of Insurance) for\npeople with preexisting conditions who couldn\u2019t get health insurance. It was\nfunded by a tax on all other health insurances sold in the state. It worked\nwell for the ten years before the ACA eliminated preexisting conditions as an\nexclusion, then the enrollment dwindled to double digits and the fund ballooned\nto $20M. Could such a plan work again?<\/p>\n\n\n\n

Some states have tried it, the reinsurance model, but each\nhas varying success based on how much cost they are willing to shift. That\u2019s\nthe key, the willingness to properly fund the investment.<\/p>\n\n\n\n

It\u2019s worth fixing this.  Most businesses in Idaho have less than 50\nemployees. There are many small shops or self-employed folks who drive this\neconomy and need this support to make health insurance affordable. <\/p>\n\n\n\n

A recent suggestion from the Trump administration was for\nstates to apply for waivers to Medicaid to allow subsidies for those above\n400%. Of course, for this to fit the budget neutral requirement, the subsidies\nfor lower income folks would have to go down to pay for the higher income folks\ncost reductions. Isn\u2019t that how it always goes?<\/p>\n\n\n\n

Polls show most people are not happy with how health\ninsurance works in this country. Why can\u2019t Idaho take some time and effort and\nmake this work for our citizens? It\u2019s worth the effort.<\/p>\n\n\n\n

<\/p>\n","protected":false},"excerpt":{"rendered":"

While the legislature struggles with modifying Medicaid Expansion, costing more, getting less insured, Governor Brad Little on the campaign trail was beating a different drum. He was looking beyond the twisted shorts condition of legislative Republicans who fought Proposition 2; … Continue reading →<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"_links":{"self":[{"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=\/wp\/v2\/posts\/991"}],"collection":[{"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=991"}],"version-history":[{"count":2,"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=\/wp\/v2\/posts\/991\/revisions"}],"predecessor-version":[{"id":995,"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=\/wp\/v2\/posts\/991\/revisions\/995"}],"wp:attachment":[{"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=991"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=991"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=991"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}