BOISE - Efforts to revamp Idaho's indigent care system died in committee Wednesday, despite favorable comments from most committee members.
The Senate Health and Welfare Committee voted 8-1 to kill the measure, which would have made all but the poorest Idahoans ineligible for county indigent medical care.
The bill, which passed the House on a 55-11 vote earlier this week, was sponsored by Rep. Janet Trujillo, R-Idaho Falls. It came in response to the Affordable Care Act, which makes subsidized health insurance available to people earning 100 percent to 400 percent of the federal poverty level.
Idaho's current indigent rules are based on the cost of treatment. If someone can't pay their medical bills within five years, they qualify as indigent regardless of income, meaning the county and/or state will cover at least a portion of their medical costs.
Trujillo's bill would leave the program in place for anyone who earns less than 100 percent of poverty, as long as they aren't eligible for Medicaid. Anyone who earns more than that would be out of luck, though, since they're required to have health insurance under the ACA.
The bill had a delayed implementation date, giving people until 2016 to sign up for insurance through the state exchange.
"The policy question we now face is whether the (indigent) program should cover individuals who have the option to purchase their own insurance?" Trujillo said.
Although several committee members appreciated the ultimate goal she was after, they questioned whether the bill would actually encourage people to buy insurance and take responsibility for their own medical costs.
"I'm afraid of changing the way we do things now because people might fall through the cracks," said Sen. Marv Hagedorn, R-Meridian. "We're picking a number, 100 percent of poverty, and saying everyone else has to have insurance. I think we need to re-address this a year from now, when we have more data on what effect the ACA has had on the indigent program and health care costs."
Under Trujillo's proposal, if an eligible individual refused to buy subsidized insurance and subsequently was in an accident, they would be responsible for the full cost of care - meaning they could face potential bankruptcy, with the hospital and medical providers being stuck with the bill.
Sen. Sheryl Nuxoll, R-Cottonwood, recommended approval of the legislation. The remaining committee members, however, supported Hagedorn's motion to kill the measure.
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Spence may be contacted at bspence@lmtribune.com or (208) 791-9168.
