JFAC hears PCAP proposal

Posted at 10:44 AM, Jan 18, 2016
and last updated 2016-01-18 19:24:02-05

Lawmakers held their first public hearing discussing a medical coverage proposal from Governor C. L. "Butch" Otter promising to service the working poor.

Health and Welfare Director Dick Armstrong presented the Idaho Primary Care Access Program (PCAP) to the Joint Finance Appropriations Committee Monday morning. He outlined the program aimed to grant medical coverage for those who make too much to qualify for Medicaid, but too little to receive subsidies through the state healthcare exchange.

"In my discussion with the governor, he's been quite adamant about covering people in the gap," said Armstrong.

The number of Idahoans in the gap has been tough to nail down. Estimates put it between 55,000 and 78,000.

Those participating in PCAP would spend roughly $32 a month to receive coverage. This would grant access to "medical homes," clinics that offer bare-bones medical assistance. It wouldn't grant complete coverage. Armstrong said some services would come with an additional fee that would be on a "sliding scale" depending on a person's income. Someone earning on the low end might pay $3 for a service that someone earning on the high end might pay $25 for.

The plan also fails to cover emergency care, surgeries, or specialty prescriptions. This has Democrat lawmakers calling the plan expensive and falling short of true Medicaid expansion. It's a critique Armstrong doesn't deny.

"Governor Otter and I have been very clear, this is not a full health plan," he said. "This is really an important step for a lot of people who have lived with ailments and they don't know what to do with it, and they let it fester and let it get worse because  they don't have $120 to go to the doctors office."

Armstrong says PCAP is designed to be a first stop and provide preventative care. If patients need more detailed care, the medical homes would provide a referral to traditional hospitals.

The H&W director said he had discussed PCAP with roughly three-quarters of the Legislature before the session and found support for the concept. However he knows it all comes down to the budget and whether or not lawmakers will fund the estimated $30 million project.