idaho college students caught in medicaid gap
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SUNDAY DECEMBER 20 2015 $2 VOLUME 151, No. 148WWW.IDAHOSTATESMAN.COM/
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NEWS ALL DAY.YOUR WAY!
Jeremy McNichols, right, is among the
many Boise State players with connec-
tions to Southern California — perfect
for the team’s trip to the Poinsettia
Bowl in San Diego. SPORTS, 1B
Bowl season is underway, including
Utah’s win over BYU. 2-3B
BRONCO BLITZ
BSU’s strongSoCal links
Mayor Dave Bieter, under
fire from activists over the
disbanding of a tent city by
the Connector and Inter-
faith Sanctuary, responds in
a guest opinion that the
homeless were living in
inhumane and dangerous
conditions there that put
themselves and others at
risk, necessitating action by
the city. OPINION, 4C
COMMENTARY
COOPER COURTWAS UNSAFE PLACE
One extended family, in-
cluding Boise sisters, has
four children on the autism
spectrum. Read about their
determination to get good
outcomes. EXPLORE, 1D
AUTISM
FAMILIES FIGHTINGFOR THEIR KIDS
President Barack Obama
and first lady Michelle met
with relatives of the 14 peo-
ple killed in San Bernardi-
no. “They’re on our side,” a
survivor said. NEWS, 15A
GUN VIOLENCE
OBAMA COMFORTSVICTIMS’ FAMILIES
Amir Piranfar, a third-year doctoral pharmacy student at the Meridian campus of Idaho State University, was
about to fall into Idaho’s cavernous health insurance coverage gap next semester, a result of his changing work
schedule, the Republican-led state government’s refusal to expand Medicaid and the State Board of Education’s
requirement that full-time students have insurance that complies with the Affordable Care Act. Fortunately, one
part of that equation has changed: The board has temporarily waived the insurance rule after discovering how
many hundreds of Idaho students were in the same boat as Piranfar. Health care reporter Audrey Dutton has the
latest. DEPTH, 1C
DEPTH: HEALTH CARE
The Medicaid gapand Idaho students
KATHERINE JONES [email protected]
After four years of watching from the
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Depth MAYOR DAVE BIETER:
THE CONDITIONS AT
COOPER COURT WERE
UNSAFE, INHUMANE 4C
GUEST OPINION
Amir Piranfar is amongthe next generation ofhealth care providers— a third-year docto-
ral pharmacy student at theMeridian campus of IdahoState University.But as he planned for his
spring semester, the future ofhis career hinged on taking outstudent loans to pay for healthinsurance that is required toattend a public university:about $155 per month for apolicy he figures he will neveruse, because it has a nearly$7,000 deductible.It’s a stark change from this
year, when Piranfar paid about$20 per month for coveragewith no deductible and tinycopayments.The only difference? His
schedule.
Piranfar is heading into thedemanding final stage of hiseducation. He won’t have timeto work. This year, he had anincome that was just barelyabove poverty level, hitting athreshold for federal assistancethat made his insurance socheap.But he will earn too little
money to qualify next year.And he doesn’t qualify forIdaho’s bare-bones Medicaidprogram, which has not beenexpanded to include low-in-come adults. Piranfar is almost
27, so he cannot take advan-tage of the Affordable Care Actprovision that says childrencan ride along on their parents’insurance until age 26.Piranfar and an estimated
hundreds more Idaho collegeand graduate students fall intoa coverage gap. They havebeen required to pay thousandsof dollars for insurance or riskbeing dropped from full-timeattendance.At the same time, the state
no longer requires four-yearpublic colleges and universities
to offer students the option ofbuying a school health plan.“I wish they had it now,”
Piranfar said. “I mean, yeah, it(was) pretty expensive but ...their deductibles weren’t$7,000.”Now that they understand
KYLE GREEN [email protected]
Students study and dine at the Boise State University Student Union in late March — around the time their university decided to stopoffering a student health insurance plan, after the State Board of Education no longer required schools to provide an insurance option.
HEALTH CARE
Idaho college studentscaught in Medicaid gap
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Hundreds going to school full time have been required to payfull price for insurance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
The State Board of Education has temporarily waived insurancerequirement while it hammers out new policy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Rules for Idaho students do not parallel U.S. law, which includesa hardship exemption. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
BY AUDREY DUTTON
SEE HEALTH CARE, 2C
‘‘JOBS DON’T REQUIREYOU TO HAVEINSURANCE. IT’S JUSTLIKE YOU’RE BEINGPENALIZED TO GO TOCOLLEGE.
Andrea Woodyard, Boise Statestudent
The Idaho Statesman’sRocky Barker and jour-nalists from otherMcClatchy newspapers
recently served up an amazingand disturbing report about the107,000 Americans whoworked in the nation’s nuclearindustry and who contractedcancer and other diseases thatcontributed to an estimated15,800 deaths linked to radi-ation exposure.These workers were exposed
to radiation during our efforts todevelop nuclear power and winthe Cold War. We put them inhazardous situations and weowe them more than our grat-itude. We are indebted to themfor their sacrifice and for theimpact their suffering had ontheir families.We owe them compensation
for tolerating serious, debilitat-ing illnesses that in more than33,000 incidents resulted incompensation following theirdeaths. In Idaho, some 400workers perished as a result ofexposure received while work-ing at the Idaho National Lab-oratory, according to the federalgovernment.Though there now is a system
for seeking compensation sincethe passage of the Energy Em-ployees Occupational IllnessCompensation Program Act in2001 — there has been about$12 billion in payouts to 53,000workers — the path for victimsand their families to get whatthey deserve has been riddledwith obstacles and frustratinginconsistencies.This has been especially true
for workers at INL dating to the1960s-70s. Whereas the em-ployees of some nuclear facil-ities can receive compensationsimply by demonstrating theyare afflicted with certain recog-nized occupational illnesses,those in Idaho have the addedburden of proving that theirwork at Department of Energyfacilities was responsible.It’s time for our federal gov-
ernment and those who managethe compensation program tolevel the playing field. At 18nuclear sites, there is a “specialexposure cohort” designation.Retirees of these facilities areautomatically granted typical$150,000 payouts and medicalcare if they manifest one of 22recognized diseases and workedat the facility during certaintime periods.Not so in Idaho. We believe
INL workers who manifestedany of the recognized occupa-tional diseases and who workedthere before 1974 should getthat same special cohort status— without having to prove any-thing else. McClatchy’sfour-part “Irradiated” seriespublished this week cites severalpossible causes of exposure atINL between 1963 and 1974.Treating Idaho workers differ-ently is reminiscent of the wayIdaho downwinders have beenignored despite mounting evi-dence of cancers related tonuclear tests in the 1950s and’60s.The fact that Kenneth Bailey
died of pancreatic cancer in 2011— combined with his 33 years asan instrument technician at INL— should be all the evidencefederal officials need to compen-sate his Idaho Falls widow. Butthat has not happened.It’s time to take care of all the
families who took care of us.
Statesman editorials are theunsigned opinion expressing theconsensus of the Statesman’seditorial board. To comment orsuggest a topic, [email protected].
STATESMAN EDITORIALINL
Sickenednuclearworkersdeservefair deal
IGUALA, MEXICO
The killer says he “disap-peared” a man for the firsttime at age 20. Nine yearslater, he says, he has eliminat-ed about 30 people — maybethree in error.He sometimes feels sorry
about the work he does but hasno regrets, he says, because heis providing a kind of publicservice, defending his commu-nity from outsiders. Thingswould be much worse if rivalstook over.“A lot of times your neigh-
borhood, your town, your cityis being invaded by people who
you think are going to hurtyour family, your society,” hesays. “Well, then you have toact, because the governmentisn’t going to come help you.”He operates along the Costa
Grande of Guerrero, the south-western state that is home toglitzy Acapulco as well as torich farmland used to cultivateheroin poppies and marijuana.Large swaths of the state are
controlled or contested byviolent drug cartels that trafficin opium paste for the U.S.market, and more than 1,000people have been reportedmissing in Guerrero since 2007— far fewer than the actualnumber believed to have dis-appeared in the state.The plight of the missing and
their families burst into publicawareness last year when 43rural college students weredetained by police and dis-appeared from the Guerrerocity of Iguala, setting off na-tional protests. Then, suddenly,hundreds more families fromthe area came forward to re-port their kidnap victims,known now as “the other dis-appeared.” They told stories ofchildren and spouses abductedfrom home at gunpoint, or who
DRUG GANGS IN MEXICO
A killer’s story: Some 30 livesextinguished, but no regrets. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Best for kidnapping is a home,early in the morning, “wheneveryone is asleep”. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
The “disappeared” won’t becoming back. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
BY E. EDUARDO CASTILLO
The Associated Press
DARIO LOPEZ-MILLS The Associated Press
There are many reasons people are killed, the man says. It may befor belonging to a rival gang, or for giving information to one.
‘‘THE (DISAPPEARED)PROBLEM IS MUCHBIGGER THAN PEOPLETHINK.
The killer
SEE KILLER, 3C
2C SUNDAY DECEMBER 20 2015Depth IDAHOSTATESMAN.COM
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WISHING YOU
GOODHEALTHTHIS SEASON
these students’ plight,state education leaderssay they will try to help.The State Board of Educa-tion has just voted towaive the insurance re-quirement while it figuresout a permanent solution.
THE GENESIS OF A
PUBLIC POLICY GAP
About 15 years ago, thestate board imposed anew rule: Full-time stu-dents at four-year Idahopublic institutions of high-er education must beinsured.“When this policy was
first implemented, wewere experiencing a num-ber of students who werehaving some type of ma-jor medical event, andthey weren’t insured, sothey went to the localhospital,” said Matt Free-man, the board’s exec-utive director.Those students’ bills
often went to the countiesand the state under Ida-ho’s taxpayer-supportedsystem for indigent med-ical care.“That was the genesis”
of the policy requiringinsurance, he said. “Thatbasically remains themain focus — a funda-mental belief that stu-dents should be insured.”A board spokesman
said students also may bemore likely to get preven-tive care, and keep thecampus healthier, if theyhave insurance.Recognizing that stu-
dents could not alwayssimply sign up for insur-ance in the pre-AffordableCare Act era, the boardordered the schools tooffer student plans.Within the past year,
the board revised that
policy to say that studentsmust have insurance thatcomplies with the Affor-dable Care Act, not cheapstopgap plans. It also saidschools no longer mustoffer a plan option.One of the schools to
discontinue its plan wasBoise State. About 2,500students at BSU had beenon the school’s plan at thetime, The Arbiter, BoiseState’s student publi-cation, reported in March.A compliance official at
Boise State told theStatesman that the schoolhas yet to kick a studentoff the enrollment rollsdue to lack of health in-surance.The university now is
considering whether ornot to seek bids for a newinsurance plan for stu-dents.“We are all in quite a
quandary right now,” saidStacy Pearson, vice presi-dent for finance and ad-ministration at Boise StateUniversity. “We justdidn’t realize that healthinsurance was going tobecome such a large chal-lenge.”
TAKING URGENT
ACTION
Several students toldthe Statesman that theirschool plans were better,or cheaper, than theiroptions now. A graduatestudent at Idaho StateUniversity in Pocatellowhose SHIP premiums —student health insuranceplan — were covered inher teaching-assistantcompensation packagetold the Statesman shenow must buy insurance,reducing her overall in-come.“Students and their
families are also facingsteep increases in pricesfor policies offered on thestate exchange, with aver-age prices for a minimalcoverage ‘bronze’ planexceeding $200 permonth,” according to astaff report prepared forthe education board’sDec. 9-10 meeting inTwin Falls.One of those students is
Andrea Woodyard, aBoise State junior in her40s who is studying socialwork.Woodyard used to have
SHIP for about $200 amonth. Now she has “nota very good” Blue Cross
of Idaho plan from Ida-ho’s insurance exchangethat costs more than $350a month.Woodyard’s father is
helping pay the bill. Shehas not used her insur-ance, she said, becausethe deductibles are toohigh.Health plan costs are
growing “almost as muchas the tuition is,” she said.“Most people are gettingstudent loans to pay forhealth insurance.”Freeman told the
Statesman that he had notheard of students takingout loans to pay for healthinsurance, though it is an
“allowable expense” forstudent loan dollars.The board staff also
noted that its policy straysfrom the Affordable CareAct. As far as the federalgovernment is concerned,Piranfar and Idahoanslike him are exempt fromthe act’s mandate that allAmericans either havehealth insurance or pay afine, because holdingthem to it would cause toogreat a hardship. Thefederal government hascarved out more than adozen exemptions, fromlow income to life trou-bles such as eviction,homelessness or domesticviolence. The educationboard’s policy does notrecognize those.“Some of these students
have established arrange-ments through clinics andother charitable organiza-tions to provide for med-ical care while attendingcollege on extremely tightbudgets,” the board’sDecember meeting mate-rials said.Woodyard goes to Terry
Reilly Health Services — anetwork of federally sup-ported community clinicsin Ada, Canyon and Owy-hee counties — for freecare.“Administrators at the
four-year institutions andboard staff members havebeen besieged by studentsand families who, underthe current wording of theboard’s policy, may not beable to continue with theirplanned studies,” theboard’s agenda said.“Hundreds of studentsare affected by the scena-rios described above.”The board decided at
this month’s meeting torethink its policy. It votedunanimously to waive therequirement until theboard passes a new policy,or Sept. 1, 2016, which-ever comes first.
A PERMANENT
SOLUTION?
When he learned of theboard’s decision, Piranfarsighed with relief. He saidhe had been working thephones trying to explorehis options for the pastcouple of months.Instead of a catastroph-
ic plan from the ex-change, Piranfar nowplans to get a Blue Crossof Idaho temporary pol-icy. It costs about $70 amonth, but it doesn’t offerthe same benefits hecould get on a regularACA-compliant plan. Still,he expects to save a lot ofmoney.As a health care worker,
Piranfar believes the tem-porary waiver is not theright answer. He thinksthe solution rests in thehands of state lawmakers.“I think they should
expand Medicaid here,”he said. “I see people whoare uninsured all the time,who get into financialtrouble because of it.”Woodyard agreed that
Medicaid expansionwould be a solution.Piranfar will wrap up
his education with aninternship in Reno nextMay.Now he’s thinking,
“Maybe I could just getMedicaid when I move toNevada.”
Audrey Dutton covershealth care for theStatesman. The college andgraduateschool sheattended bothrequireinsuranceand offerstudent plansthat, for2015-2016, cost $181 and$232 per month,respectively.208-377-6448,@IDS_Audrey
FROM PAGE 1C
HEALTH CARE ‘‘PREVIOUSLY, I WAS COVERED BY SHIP(AT) $1,024 PER SEMESTER, TAKENDIRECTLY FROM MY GRANTS ANDSTUDENT LOANS. ... MY CURRENTCOVERAGE (COSTS) $1,410 PERSEMESTER. I HAVE A $5,000 ANNUALDEDUCTIBLE, AND NOTHING ISCOVERED UNTIL THAT AMOUNT IS MET.BECAUSE I GO TO SCHOOL FULL TIME,AND ONLY WORK PART TIME, I DO NOTQUALIFY FOR ANY SORT OFASSISTANCE WITH THIS COST. I SIMPLYPAY FOR INSURANCE I CAN’T AFFORDTO USE.Anthony Reynolds, Boise State student
‘‘I EVEN GOT HOLD OF ONE OF THEYOUR HEALTH IDAHO COUNSELORS,AND THEY COULDN’T BELIEVE MYSITUATION. THEY WERE AT A LOSS.Amir Piranfar, Idaho State University-Meridianpharmacy student