REXBURG — Brigham Young University-Idaho officials said Wednesday that the university decided to stop accepting Medicaid to waive a student health plan due to concerns for local health care providers.
“Due to the health care needs of the tens of thousands of students enrolled annually on the campus of BYU-Idaho, it would be impractical for the local medical community and infrastructure to support them with only Medicaid coverage,” the university said.
But will Medicaid expansion, which takes effect Jan. 1 and is expected to increase Madison County’s Medicaid rolls by nearly 3,000 people, really be a burden on health care providers in Rexburg? And why haven’t the university’s radio station and student newspaper been reporting much on a debate that is garnering national attention?
Word came out last week that BYU-Idaho would no longer accept Medicaid to waive the student health plan, meaning students on Medicaid would either have to find other insurance or buy a student health plan, which costs $536 per semester for an individual and can be $2,130 for a family.
The new policy prompted a backlash from students, who have been urging university officials to reconsider, using social media to organize and share their concerns and put together a petition that had more than 7,000 signatures as of Thursday afternoon. University officials initially declined to comment on the change, except for a brief statement on Nov. 15 confirming the new policy. Wednesday’s statement went into some more detail and said the university would work with students who previously had qualified for a Medicaid waiver.
“Many private insurance plans can cover the insurance waiver,” the statement said. “Students are encouraged to find the insurance coverage that works best for them. The BYU-Idaho Student Health Plan will continue to be an option.”
BYU-Idaho communications staff didn’t return requests for more detailed comment Thursday.
Doug McBride, spokesman for Madison Memorial Hospital, said the hospital was not in communication with the university on this topic before the university decided not to accept Medicaid. He said the hospital and those associated with it have not expressed concern about acquiring more Medicaid patients and that Madison County has a strong medical community ready to handle the county’s needs.
Nichole Jeppesen, a family nurse practitioner at Complete Family Care, said it was not a concern for her either and that she has not been contacted by the university.
”It can increase our business,” Jeppesen said. “We currently take Medicaid patients, and we have enough providers to meet the needs of an increasing population and the Medicaid expansion.”
Jeff Hopkin, a doctor at Upper Valley Family Practice, said he isn’t worried either and welcomes new patients.
"I don’t have any idea what they’re doing, it doesn’t seem right to me,” he said. “I don’t know if they are distancing themselves from the government to do what they think is right. ... I have no idea what their motivation is to have students have independent insurance. The county has the highest indigent (rate) in the state because of students who have babies. And they’re poor.”
As well as local media, the controversy has been drawing some attention from bigger media outlets, with reporters from the Salt Lake Tribune, the New York Times and others working on stories about it. Largely absent from the coverage, however, has been BYU-Idaho’s student media. The student newspaper Scroll wrote an in-depth article last week when the news first broke, but since then has only been posting the university’s official statements on its website. Scroll staff has been told the newspaper’s funding could be at risk if they cover the controversy, according to a recording of a staff meeting obtained by the Post Register.
“Basically, the deal is, there are people that would be very happy to cut Scroll funding in the Kimball (administrative) building, and so we keep getting told to not poke the bear,” a Scroll staffer said.
The staffer noted that national news outlets have been looking into the story and starting to write profiles of students. Scroll reporters have done similar work but have been told not to publish it even in other news outlets, as individuals not representing the school paper, the staffer said.
“They’re probably not ever going to be published,” the staffer said.
Some Scroll reporters in the recording said they were angry at the decision.
“Basically our free speech just got flushed down the toilet because we work at a private university,” one said.
Staff at the university’s radio station KBYI, which is part of a different department than Scroll, has also been told by the administration not to cover the controversy, according to multiple sources with knowledge of what happened.
McBride said the impact of Medicaid expansion, both on medical providers and on county and state finances, remains to be seen. During the 2020 session, lawmakers are expected to decide whether and how much to charge counties to pay for part of the cost of expansion, and if the state goes with a formula based on enrollment, Madison County and others in eastern Idaho that are expected to have high expansion enrollment could take a hit. However, McBride said Madison Memorial officials feel ”fully capable of handling any volume of patients.”
“I really appreciate and respect BYU-Idaho trying to be fiscally responsible to our community,” McBride said. “I do not particularly see right now there being a lot of extra burden put on providers at this point.”
The state Department of Health and Welfare tracks Medicaid signups by age. As of Thursday, 796 of the 1,615 Madison County residents who had signed up for expanded Medicaid were between the ages of 19 and 25. Out of the county’s 8,062 total Medicaid enrollees, 1,487 were between 19 and 25.
Coleen Niemann, spokeswoman for Eastern Idaho Regional Medical Center in Idaho Falls, said more people with any insurance is a good thing for the system.
“The more opportunities people have to receive preventive health care and basic health care because they have insurance, the better off they are, and it also increases appropriate use of the (emergency room) for emergency health care needs,” she said.
Medicaid reimbursement rates are often lower than Medicare and private insurance. However, Niemann said rates can also differ greatly even between private plans, and hospitals and private practice physicians are used to dealing with that.
“In the end, we support people having insurance because it means more people getting access to the right health care at the right time regardless of what type of insurance that is,” she said.
DHW’s list shows 11 primary care providers in Madison County who accept adult Medicaid patients.