One of the oddest things is playing out in Eastern Idaho at Brigham Young University-Idaho.
In 2018, Idaho voters chose to expand Medicaid eligibility for those up to 138% of the poverty line. An estimated 91,000 Idahoans are expected to be covered and coverage begins this coming January.
Like many colleges and universities, BYU-Idaho requires attendees to have health insurance. As the average student enrolled either does not work or has a low paying job, many are already on Medicaid and more will be covered in January with expansion.
Madison County, where BYU-Idaho is located, has the highest poverty rate in Idaho. It is anticipated it will have a large number of new Medicaid enrollees, adding to the current significant local number.
In the past, BYU-Idaho allowed students who were enrolled in Medicaid to count that coverage toward the health coverage requirement. Often, covered students are married with children (or one on the way). Reports are that just a month ago the university was telling students enrolled for January that Medicaid would satisfy the requirement.
In the last week or so BYU-Idaho did a 180, telling students that Medicaid coverage is unsatisfactory and that any who are so covered will be required to purchase an additional BYU student health plan at a cost of $536 an individual or $2,130 a family per semester.
Many students reacted in shock, pointing out that with Medicaid they would not need the student health plan and that the cost of the unneeded BYU-Idaho plan would be burdensome.
Even weirder was the explanation (or lack thereof) for the change provided by BYU-Idaho. Nathan Brown of the Post Register reported that the student health center, when asked by students, pointed the finger at the governing board which is made up of LDS Church leadership. But, an inquiry to Salt Lake was referred back to BYU-Idaho and BYU-Provo chimed in (on Twitter) that it was still accepting Medicaid, indicating that it wasn’t a church-level decision.
The university stonewalled and refused to comment at all until late last Friday when it released the following statement:
“Brigham Young University-Idaho has decided to not accept the Idaho Expanded Medicaid program, which takes effect January 1, 2020, to serve as an insurance waiver option for students. BYU-Idaho is working with students, on a case-by-case basis, to help them with their healthcare options.”
That statement raises more questions. First, the language seems to specify that students can’t use Medicaid if they are in the group that gets coverage in January, implying that those who had coverage in the past might be OK. Why the difference in treatment, if accurate? Second, there is still no justification provided for the change in the first place.
I have been told that the policy originated with BYU-Idaho administrators who had heard from the local medical community that they were fearful of being flooded by large numbers of new Medicaid-qualified patients. If so, that is an odd overreaction. Doctors have the full right to accept or reject Medicaid patients. Moreover, there is a much larger medical provider network 20 minutes away in Idaho Falls. Many of the students live there anyway.
Another assertion is that Medicaid expansion was rejected by Madison County voters 54% to 46%, meaning that the decision merely reflects the local electorate. Others have similarly wondered if this is an attempt to minimize the impact on Idaho taxpayers. If so, consistency would require rejection of Pell grants and other forms of education aid flowing to the university. If this is merely some sort of “political” decision, then shame on those who put their ideology above the interest of their student body. I hope these points are unfounded.
Still others believe that BYU-Idaho merely wants the revenue from enrolling more students in its student health plan. The idea is that fees paid for services covered by Medicaid would be a significant windfall. I have doubts on this one.
There may be another, yet unknown, explanation.
Students have launched an online petition and there is talk of a formal protest.
If I were advising the university, I would recommend reversing the decision for the next semester and then, if there is a valid justification, revisit the issue. The current “hurt students with no justification” approach is untenable.