Local column: Idaho’s first step to better health care

The plan for Idaho to apply for health care waivers is a good first step. But remember, it’s only a first step, writes Sarah Droegemeuller.

Idaho has made a smart first step toward closing the Medicaid gap.

Right now there is a proposal to offer waivers (1332 Waiver and 1115 Waiver) for low-income Idaho adults and those with medically complex health conditions, offering them coverage through a tax credit.

It is estimated that 35,000 adults would gain access to affordable health insurance through this proposal. In the coming 2018 legislative session, our representatives will vote on this proposal.

Will this proposal be enough?

Well, it’s a good first step. It will offer people like my son a chance to have continued coverage. As a young adult, my son is working part-time, living at home, and saving money for a mission. He makes enough to file taxes but not enough to qualify for any subsidized plans through the exchange. Without coverage, he may not receive the care he needs for his mental health conditions.

As a child with Autism Spectrum Disorder, my son was thankfully covered by Medicaid growing up. But at age 19, he no longer receives coverage. Now he has no access to a primary care doctor to maintain his prescriptions and monitor his behavioral health. He can’t see his counselor anymore. We have been compliant with the Affordable Care Act and purchased for him a single person insurance plan. He works three jobs now, one of which goes to pay his insurance premium.

Starting in January, this health plan, which only covers major medical and hospitalizations after a $5,000 deductible, goes up 30 percent. We’ll be switching to a plan found on the Your Health Idaho exchange, though the coverage is only minimally better and he still does not get any subsidies or tax credits.

The stress of his life situation is not helpful to his mental health. If he could qualify for a waiver and receive a health care tax credit, his insurance would be much more affordable and he would still be able to receive his care. I pray that this proposed solution goes through so that he might be relieved from the stress of scrambling to pay for an inadequate health care solution.

One of the shortfalls of the proposed Idaho Health Care Plan is that it excludes severe mental illnesses from the 1115 Waiver’s list of high-cost and medically complex health conditions.

Idaho is already deficient in its behavioral health system. This will exacerbate the needs of the vulnerable in Idaho. This is why it’s just a first step, and I hope much more can be done to benefit those who work but don’t earn enough income to afford health care in Idaho.


Sarah Droegemueller is an author and educator who lives in Idaho Falls. You can read her blog at manytruewords.blogspot.com.


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