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With ACA, does Idaho need a Catastrophic Fund?

By Emily Valla
Published On: Jan 22 2014 07:22:10 PM CST

With ACA, does Idaho need a Catastrophic Fund?

Under the Affordable Care Act, most people are required to have health insurance. So, does Idaho still need to have a catastrophic fund?

For 30 years, the catastrophic fund has picked up the tab for people who cannot pay medical bills within five years. Counties pay up to $11,000 of indigent medical bills. The state then has to pick up the rest. Annually, Idaho spends about $55 million of taxpayer money on medical bills. Lawmakers are now considering several options that range from cutting the program completely to letting the program continue to grow.

"One of the proposals is to clearly state that we are not responsible for anybody over 100 percent of poverty level, and that's the population that can qualify for the exchange," said Roger Christensen, a Bonneville County commissioner and Catastrophic Board chairman.

If the indigent fund only had to pay for those under 100 percent poverty, the state would save about $12 million. Cutting the program nearly triples that number.

"The impact at the state level there would be approximately $35 to $40 million in savings in state general, and the counties are putting in another $30 or $40 million and that come from the property tax," said Christensen.

Even under the nation's new health care policies, there are some people who still might not have insurance. Those under the poverty line would still need help with medical bills. Individual states had the option of expanding Medicaid, something that, thus far, Idaho has chosen not to do.

"Idaho has their own state exchange but they haven't expanded Medicaid. So the way the program goes forward is those who are at 100 percent of poverty or less would still come to the indigent fund. Anybody who can buy insurance on the exchange, they are in an income bracket between 100 and 400 percent of poverty level," said Christensen.

There is also talk of following Arkansas' example. Essentially, the state is using Medicaid funding to purchase insurance off the exchange.

There is not a specific timeline to make a decision.

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Earlier this week, Christensen presented the costs of the Catastrophic Health Care program to the Joint Finance and Appropriations Committee.  The six options were:

1. Repeal the indigent program

2. Expand Medicaid 

3. Marketplace option for the uninsured (private industry)

4. Purchase from the Insurance Exchange

5. Maintain the status quo

6. Return to the original intent and design of the program


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