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Close the Gap Coalition: Otter's Medicaid Gap Solution Not Nearly Enough

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KELSEY HAWES
  • Kelsey Hawes


A coalition of Idaho caregivers and business owners advocating for closing the so-called Medicaid Gap, which leaves nearly 78,000 Idahoans in the gap between Medicaid eligibility and qualifying for health care on the state's insurance exchange, say Gov. C.L. "Butch" Otter's plan to address the issue doesn't accomplish nearly enough.

The governor's plan, which Otter hinted at during a Jan. 8 legislative preview but was oddly absent from his State of the State address on Jan. 11, would set aside $30 million in state funds to help pay for initial health care assessments at participating clinics. Thereafter, the state might pay for services on a sliding fee scale.

According to the Close the Gap Idaho coalition, Otter's plan, which was met with some support from the Idaho Legislature's Republican leadership, only "partially solves the problem." The group added that the proposal was "insufficient to manage existing or ongoing ailments." For example, the coalition said, the proposal would not cover essential or life-saving treatment of cancer, diabetes and other serious diseases.

As an alternative, the coalition supports the so-called Healthy Idaho Plan, which would grant access to specialty care, emergency room visits, ambulance transport, hospitalization and full prescription care.

"It's essential that everyone understands [Otter's Primary Care Access Program] 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," said Dr. Ted Epperly, CEO of Family Medicine Residency of Idaho. "I applaud the governor for his initial efforts to help the gap population, but we must still close our health care coverage gap through implementing the Healthy Idaho Plan."