At a press conference on January 7th Governor Otter unveiled an alternative plan to expanding Medicaid to the 78,000 Idahoans who fall through the gap because they are  making too much to qualify for Medicaid but too little to qualify for subsidized health insurance through the state health insurance exchange.  The plan is called the Primary Care Access Program.

The program would  provide preventive, primary medical care to the estimated 78,000 Idahoans who now fall into the “gap” population. He proposes a $30 million program funded solely with existing state tobacco taxes.

The program would spend approximately $32 a month per patient for them to access to a “medical home” which would be a regular health care provider who would be familiar with the patient’s health history and could coordinate their care.Patients would go to clinics in their area, which would expand hours to serve them, including weekends. The program wouldn’t cover hospitalization or specialty care.

The program is endorsed by Health and Welfare Director Dick Armstrong, Senate Health and Welfare Chairman Lee Heider and House Health and Welfare Chairman Fred Wood. 

To read the statements from Senator Lee Heider and Rep. Fred Wood read Betsy Russel's article here.

In response to the Primary Care Access Program (PCAP) proposal, Close the Gap Idaho hosted a press briefing on the differences between the PCAP and the Healthy Idaho Plan. Attached, you will find the press release provided to statewide media outlets. During the briefing, Neva Santos, Executive Director of the Idaho Academy of Family Physicians, stated, “It’s critical to understand that the proposed Primary Care Access Program is not health insurance coverage.” Further, Ted Epperly, CEO of Family Medicine Residency of Idaho, went on to explain, “It is essential that everyone understands PCAP would be limited to just primary care and preventative care, with basic lab, x-ray, pharmacy and limited office based behavioral health services, depending on availability at a given clinic.” The event was well attended and received great media coverage ( read Betsy Russell’s Eye on Boise story).

You can learn more about the PCAP by downloading the Department of H&W’s PCAP Summary and PCAP FAQs. Additional Primary Care Access Program (PCAP) takeaways:

1.      The PCAP is not an alternative to the Healthy Idaho Plan or Medicaid expansion. The PCA does NOT replace health insurance and will NOT consistently cover medications, acute care, emergency room visits, labs/x-rays, or behavioral health services.

2.      The PCAP will not close the coverage gap; 78,000 Idahoans will still lack access to affordable health insurance. Because thousands will still fall into the coverage gap if the Healthy Idaho Plan is not passed, Idaho will continue to see the tragic consequences – hundreds of deaths, thousands of suffering families, and too many medical bankruptcies. What’s more, our economy will miss out on 15,000 new jobs and hundreds of millions of dollars in the new economic activity each year.

3.      The PCAP will cost Idaho taxpayers an additional $30 million. State and county indigent funding for hospital and special care will continue to be needed (last year, the total indigent costs were $36 million), and taxpayers will continue to pay for Medicaid expansion in other states (over the next eight years, Idaho will send $1.2 billion of our federally paid taxes to other states).

In his State of the State address Governor Otter proposed funding an additional behavioral health community crisis center for the state at a cost of $1.7 million.

In 2014 Otter first proposed establishing crisis centers for the mentally ill in three Idaho cities. To date, two of the centers have been created in Idaho Falls and Coeur d'Alene. The centers help individuals with mental illness who might face jail, emergency room treatment or other expensive interventions that often don't provide effective or ongoing help for their problems.

The newest center would be located  in southern Idaho.

The Division of Vocational Rehabilitation is pleased that the Governor is supporting two very important line items in their FY17 budget. The first is $270,600 in general funds for the VR program.  This will allow the department to capture $1,000,000 in federal funds.

The second is $340,000 in general funds for the EES program.  This will allow a reduction of the wait list.

The Governor did not recommend an additional position for the Council for the Deaf and Hard of Hearing. 

8:00-8:30 Idaho Behavioral Health Plan presented to JFAC From the Office of Performance Evaluation

8:30 a.m. to 9:10 a.m. Division of Medicaid

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9:20 a.m. to 10:00 a.m. Division of Medicaid (continued)

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