How Phil Batt fixed a piece of health care
Marty Trillhaase
October 11, 2009
Lewiston Morning Tribune
The latest Census information shows a dramatic turnaround in the fortunes of Idaho's children. More than a decade ago, one of every five of them lacked access to health insurance. Today, that number has been reduced by half.
And for that, you can thank a self-professed tightwad in the governor's office.
Democrats had held Idaho's Statehouse for a generation by 1994 when Republican Phil Batt was elected, promising to get a grip on state spending.
Four years later, Batt left office with a reputation of another kind - an executive big-hearted enough to look out for the dispossessed of society and one with the political acumen to see his policies enacted.
It's the stuff of legend now to remember how in 1996, Batt, a Wilder onion farmer and Statehouse veteran, twisted the arms of his Republican friends in the Legislature to change the worker compensation insurance laws so that farm workers hurt on the job could get help.
Strangely, that story has obscured an equally vital portion of Batt's legacy.
Idaho is a low-wage state where many parents earn too much to qualify for Medicaid, but too little to afford insurance in the private market.
In the mid-1990s, Congress offered states such as Idaho a remedy. Called the State Children's Health Insurance Program, it allowed more kids to obtain Medicaid by increasing income eligibility limits. The federal government also paid more of S-CHIP's costs, although Idaho taxpayers would be on the hook for about a fifth of the cost.
Perhaps following the theory that it's better to apologize later than seek permission, Batt implemented S-CHIP administratively, essentially daring the Legislature to reverse him. Although lawmakers trimmed it back a bit, they went along with the governor.
So instead of delaying treatment until a child's ailment festered and required the most expensive kind of care available from a hospital emergency room, kids were getting checkups from a family doctor. They were getting preventive care. They were getting vaccines.
Legislators were worried that expanding Medicaid would deplete the state budget and refused to advertise the program, however. Filling that void was the Robert Wood Johnson Foundation, which stepped in with an outreach program.
Then the unexpected happened. For every four children who applied for S-CHIP, three came from families so poor they already qualified for Medicaid. It took S-CHIP to bring them to the table.
As of last summer, the number of Idaho kids on S-CHIP was at 31,079. The number covered by traditional Medicaid was 147,860.
The latest Census numbers tell the story. While 17.8 percent of Idaho adults lack health insurance, the percentage of Idaho's children without access to a health insurance plan dropped from 19.8 percent in 1999 to 8.9 percent.
How do you quantify Idaho's return on that investment? It just goes to reason that a healthier child has a chance of leading a happier, more productive life as an adult.
Batt doesn't get all the credit. Legislators would have come around to the idea of embracing S-CHIP. In fact, they eventually expanded the pool of kids eligible for S-CHIP.
But Batt did what a good governor does - he pushed lawmakers into doing the right thing a little sooner.
Originally posted at http://www.lmtribune.com/story/opinion/46428/
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