Malek sponsors health care legislation
BOISE — The $28.9 million in a Senate bill that’s been hanging fire in the Idaho House since late January could be used to offset health care costs for thousands of uninsured Idahoans, state Rep. Luke Malek said last week.
Malek, a Coeur d’Alene Republican, is the House sponsor of Senate Bill 1201, a measure originally intended to return nearly $30 million in savings from Idaho’s Catastrophic Health Care Program — commonly known as the CAT Fund — back to the state general fund.
SB1201 rocketed to the House after a 33-0 Jan. 27 Senate vote, but House Republican majority leaders applied the brakes to it, and have been looking — along with other state lawmakers — at alternative uses for the $28.9 million.
“It’s been there (on the House third reading calendar) for a while, but there’s been a lot of conversations about what the appropriate use of that savings is,” Malek said. “And, no consensus. So, for me to guess where that might end up, I have no idea.”
In addition to the idea of bolstering health care funding for an estimated 78,000 uninsured Idahoans, Malek and Rep. Marc Gibbs, R-Grace, said some sort of tax cut has been considered based on the moneys available in SB1201.
“Tax relief,” Malek acknowledged. “Or, it could go to other programs that I haven’t heard about yet.”
Along with discussions with other members of the House GOP leadership team, House Majority Caucus Chair John Vander Woude said in a Friday interview that he has been working House Health and Welfare Committee Chairman Fred Wood, R-Burley, on ideas for SB1201 spending. Among the ideas: Fund Medicaid expansion to start to generate billions of dollars in federal aid for Idaho health care costs, put money into the $30 million Primary Care Access Program (PCAP) suggested by Idaho Republican Gov. Butch Otter, or a hybrid approach including those ideas.
“I don’t think PCAP will be what comes out of here,” said Vander Woude, a Nampa Republican.
Legislative budget analyst Jared Tatro noted the $28.9 million in SB1201 is one-time money and PCAP has been proposed as a year-to-year ongoing program.
Malek advocated a combination of a primary care fund similar to PCAP (which isn’t insurance, but a plan the Otter administration suggested would pay $32 per basic doctor visit) and a public health insurance plan to cover low-income Idahoans for more extensive medical costs.
“PCAP is an Idaho-based plan that says ‘Here’s how we’re gonna drive appropriate utilization,’” Malek said in a Wednesday interview. “Couple that with some sort of (insurance) coverage plan. I think that’s what we need as a solution.”
Malek explained during a Wednesday interview that the state’s health insurance exchange (“Your Health Idaho”) in recent years has helped to reduce the dollars spent by the CAT Fund. “We were able to insure more people,” Malek said, regarding the savings.
That savings led to the Senate’s January action to return some of the unspent moneys from state fiscal year 2015 and the current state budget year to the state general fund.
“I would like to see it invested back into some sort of Idaho health plan to cover those (uninsured) individuals,” Malek said. “For all care, comprehensive care.”
Otter’s PCAP program idea was unveiled four days before the Jan. 11 start of this year’s legislative session — but, in the legislative struggle to identify funding sources, the governor’s plan hasn’t taken wing. Still, there has been a concern expressed by many people, including state legislators and the executive branch, that 78,000 uninsured Idahoans in what’s commonly called the “gap population” need help covering their health care costs.
“I don’t know that it would be Medicaid expansion,” Gibbs said of the possible outcome of SB1201 action, “but a medical plan to help the gap population as we know it.”
Vander Woude said it’s unlikely the $28.9 million designated in SB1201 would be redirected to a “straight-out Medicaid expansion.”
“It (Medicaid expansion) might be somewhere in the mixture as far as a long-range plan,” Vander Woude said.