Ada County’s Indigent Services medical payments budget is increasing by a half a million dollars, from $2.9 million to $3.4 million, this coming fiscal year. Sadly, that increase might not be enough.
According to state law, County property taxpayers are required to pay the necessary medical expenses for people whose income, minus their legitimate expenditures, do not have enough money left over to pay their own medical bills. The county pays at the Medicaid rate, which is about 40 percent of what is usually billed for services.
This portion of the budget is increasing for two reasons. We are expecting more claims to be filed in the current dismal economic climate. The rest of the increase is due to a change made by the Idaho Legislature.
In prior years, the county’s maximum payment was $10,000 per applicant, per year. Because of the legislative change, the county’s maximum payment has increased to $11,000, which will cost Ada County property taxpayers an extra quarter of a million dollars a year. Allowable medical expenses beyond that are paid by the State’s Catastrophic Board.
Hard as the $1000 increase is to accept, it sure beats Governor Butch Otter’s proposal, which was to raise property taxpayers’ share of medical payments to $15,000 per applicant, per year. Had the Legislature gone along, Ada County property taxpayers’ obligation would have increased by $1.25 million. The governor was trying to balance the State’s budget on the backs of local property taxpayers.
Ada County Indigent Services does not run a traditional welfare program. The county places liens on each applicant’s real and personal property and, whenever possible, requires repayment. Realistically, however, only a small percentage of what is paid out gets reimbursed.
This discussion will be ongoing over the next several years, and begs the question: whose responsibility should it be to bear the burden of the cost of providing necessary medical services to those people who are uninsured and unable to pay?