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BOISE, Idaho (AP) — Idaho's health care system for the poor has been stretched to its limits and needs an overhaul, the program's director said Thursday.
The Catastrophic Health Care Cost Program handled fewer cases last year than it had previously, but it continued to be burdened by issues such as mental health care, Roger Christensen told state budget writers.
"We've done about as good a job as we can to get this program operating as efficiently as possible," Christensen said.
"It's still a Model T Ford," he added, calling the CAT system outdated. "And you probably don't want to get on the freeway in today's driving environment."
The CAT program handled about 1,100 cases last year, down from nearly 1,300 cases in 2010.
The state's health insurance exchange has helped with the reduced load by identifying patients eligible for subsidized care. CAT officials also have begun to require checks to determine whether patients qualify for other benefits.
Revenue from the state general fund and county property taxes pay for the program, which cost about $53 million in fiscal year 2014. Christensen said he was cautiously optimistic that the cost was dropping. He expects CAT will cost the general fund about 8 percent less this year, but the county expenses were not immediately clear.
The program faces challenges despite the reduced caseload, he said. Caring for uninsured mental health patients, who frequently land in emergency rooms and county jails, has been a significant problem.
"We continue to struggle with that, especially the jails," Christensen said. "Mental health continues to be a major concern of ours."
He called for an overhaul, saying that any alternative would be an improvement over the current system. He stopped short, however, of calling for an expansion of Medicaid under the Affordable Care Act.
Idaho lawmakers have consistently resisted expanding Medicaid eligibility, with Republican leaders saying they don't trust promises from the federal government to pay for the program.
That position is unlikely to change this year as House Majority Leader Mike Moyle has lawmakers will focus this year on education and transportation.
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