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November 26, 2019

Updated: BYU-Idaho reverses course on Medicaid coverage policy

Daily Briefing

    *Editor's note: This story has been updated to reflect BYU-Idaho's Monday decision to reverse its policy on Medicaid coverage. 

    Brigham Young University-Idaho announced Monday that it has reversed a policy change that would have eliminated Medicaid as an adequate health insurance option for students.

    BYU-Idaho, the largest private university in Idaho, made the original announcement to no longer accept Medicaid as the sole coverage option for students earlier this month. Like many colleges, BYU-Idaho, the largest private university in Idaho, requires all students to have health insurance before they can register with the university. However, the university’s original decision to no longer include Medicaid as an accepted form of insurance "blindsided" students who are covered exclusively by Medicaid and would have been forced to either purchase additional coverage or leave the school.


    Why did BYU-Idaho make the original decision?

    In an email to students earlier this month, BYU-Idaho suggested the change was in response to the state's pending Medicaid expansion.

    Idaho voters last year approved Proposition 2, which directs the state to expand Medicaid to individuals under the ACA. After some legal challenges, the full expansion is set to take effect this January. According to the New York Times, about 70,000 low-income Idaho residents, including college students, are expected to qualify for coverage under the expansion.

    The university in the letter expressed concern that local providers would not be able to handle an influx of Medicaid patients. According to the Salt Lake Tribune, an influx of students on Medicaid "would be impractical for the local medical community." While the university has not stated how many of its students would qualify for Medicaid under the expanded program, state data suggest about 2,400 people in Madison County, where the university is located, are expected to enroll in the expanded coverage.

    Local providers refute capacity concerns

    However, Madison Memorial Hospital, a county-owned facility that serves the BYU-Idaho student community, said it has no concerns about its ability to handle new Medicaid enrollees.

    "We have some great providers here, and we feel like we're able to handle any growth that the university and the community would need," Doug McBride, executive director of business development at Madison Memorial Hospital, said.

    Lori Sessions, CEO of Grand Peaks Medical and Dental, a community health center that serves Medicaid and other patients, also said her clinic has been working to improve capacity in light of the state's Medicaid expansion.

    "We are currently expanding to provide more access to medical, dental, and behavioral health services in all Grand Peaks locations in anticipation of the influx of patients that Medicaid expansion could possibly bring," she said.

    Clay Prince, a physician at a private family practice and also the chief medical officer at Madison Memorial Hospital, took aim at BYU-Idaho's decision and rationale. "The explanation lacks a certain credibility because I really don't think BYU-Idaho officials asked the local medical community whether we felt local resources are able to support an influx of Medicaid enrollees from the college," Prince said.

    Students 'blindsided' by university's decision

    For students who choose to purchase new coverage, one option was to buy into the school's coverage option, which is administered by Deseret Mutual Benefit Administrator (DMBA) health plans. However, DMBA is not legally an insurance company, and therefore its plans don't have to comply with the ACA's minimum essential coverage requirements.

    For some students, that might have meant important medical care would not be covered. "They can't treat any single one of my medical diagnoses," said Jessica Knoeck, who has severe rheumatoid arthritis, fibromyalgia, and lupus. Knoeck planned to enroll in BYU-Idaho and expected to be covered by Medicaid under the expansion. "Buying their medical plan makes no sense," she added.

    The plans also don't include care for pregnancies or for a student's spouse who is not a student at the school.

    "This imposes a financial burden that doesn't really seem necessary," according to Tanner Emerson, a senior at BYU-Idaho who, along with his wife, is currently covered by Medicaid. "It happened overnight, came out of nowhere and blindsided us."

    Other students, such as 24-year-old Casey Wilson—who is married with two children and relies on Medicaid and other public assistance to afford rent, groceries, and school—raised concerns about affordability and questioned whether they'd be able to return to school at all. Wilson was only a few credits away from her degree when she learned that she might not have been able to go to school with Medicaid coverage.

    "I am devastated," she said. "I love school. I want to graduate. But we're a struggling family, and we don't have the money for [private insurance]. … There's just not $500 sitting around."

    BYU-Idaho reverses policy

    On Monday, BYU-Idaho sent out a new email announcing that it will retract its new health insurance policy and allow students who are exclusively covered by Medicaid to enroll.
    "The well-being of our students and their families is very important to us," BYU-Idaho administrators wrote in the email. "We are grateful for the feedback we have received from our campus community and for the input of the local medical community. … We have decided that Medicaid, as it has in previous years, will meet the health coverage requirement at BYU-Idaho" (Tanner, Salt Lake Tribune, 11/26; Tanner, Salt Lake City Tribune, 11/22; Price, EastIdahoNews.com, 11/20; Kliff, New York Times, 11/24).

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