The 2017 Idaho Legislative Session is now in full swing, and our journey is now underway. With the inauguration of President Trump on 01/20/2017, the journey should prove an interesting one in terms of healthcare policy. This week we'll look at the implications of the incoming administration, explore a few items of proposed legislation in depth, and look at opportunities to get involved during advocacy days. Thanks to all who contacted me over the past week. Your feedback was most welcome! Again, if you have questions, comments, or suggestions regarding issues or items that you would like to see followed here, please feel free to contact me at: tiffenystees.policyintern@gmail.com.
A New Era
Almost directly after his inauguration, President Trump issued a one page, executive order in the first official step toward dismantlement of the Affordable Care Act (ACA). The New York Times reported that the order's, "broad language gave federal agencies wide latitude to change, delay or waive provisions of the law that they deemed overly costly for insurers, drug makers, doctors, patients or states." Hence, the thrust of the ACA law is effectively removed by this act even prior to an act of Congress moving to repeal it. Read the full text of the NYT's report here
What does this mean for Idaho? Your Health Idaho Director, Pat Kelly, told the Idaho House Health and Welfare Committee on 01/18/2017 that, "depending on what the [ACA] repeal would look like," Idaho's health insurance exchange stands to lose $220 million in tax subsidies. As such, 82,650 Idahoans would stand to lose their tax credits which currently assist them in offsetting costs of current health insurance coverage. At present, no alternative to the ACA exists, as was noted in an interview with Kimberlee Kruesi of the Associated Press by Rep. Ilana Rubel (D-Boise). Rep. Rubel stated that, "it's imperative the public know what's at stake under a possible repeal of Obamacare." Read the source material for this paragraph here.
Idaho College of Osteopathic Medicine (ICOM) Residences Update
Last week in his State of the State address, Governor Otter welcomed the ICOM, a (currently unaccredited) for-profit medical school, stating that they had secured 78 residency positions at healthcare facilities across the state. These same residencies were to be instrumental in increasing access to healthcare for all Idahoans as reported in the same address. However, a new report from Associated Press', Rebecca Boone, indicates that said residency spots do not as yet exist, and that the board responsible for their approval, "has denied the first step in creating them." To read Boone's full report at the location of this writer's access to the same, click here.
Upcoming Advocacy Days & Involvement Opportunities
January 25th: Regarding S1009 - DEQ will be presenting its proposal to the Senate Health and Welfare Committee on Wednesday, Jan 25, at 3 pm. A follow-up hearing by the House Environment, Energy and Technology Committee is likely next week. This legislation will weaken the restrictions on field burning, in place to protect air quality. For more information on this bill, see the piece written below ("Idaho Air").
January 27th: Public hearing - Close the Gap! Health and Welfare listening session from 8 to 11 a.m. (plan to arrive at 7 a.m. to sign in). All are encouraged to attend, participate, and speak out on this vital issue.
The disability community is strongly encouraged to attend and speak out about closing the gap, non-emergency Medicaid transportation, mental health services through Optum Idaho, and more! For more information contact the Idaho Council on Developmental Disabilities at 208-334-2178.
February 7th: AARP Idaho, 1st floor, Capitol
February 21st: Consortium for Idahoans with Disabilities, 1st floor, Capitol (for more information visit CID on Facebook here
February 27th: Alzheimer's Association Idaho, the Capitol. Be visible and wear purple to show your support!
Looking ahead...
The leadership team of the Idaho Caregiver Alliance (ICA) is working on a draft Concurrent Resolution for presentation to the legislature. The intent of the resolution is to broaden awareness of the issues facing unpaid family caregivers. It will also raise awareness of the recommendations for supporting caregivers in the ICA's Lifespan Family Caregiver Action Plan. For more information about the ICA, its mission, and the Action Plan visit their site here.
Bills in Spotlight
Idaho Air
The Idaho Department of Environmental Quality (DEQ) has proposed bill, S1009 (01/1/2017 Reported printed; referred to Health and Welfare), that addresses the issues of crop residue burning vis a vis required National Ambient Air Quality Standards (NAAQS) in rural Idaho. Idaho Code 39-114 requires the DEQ to evaluate air quality conditions before approving crop burn days. Currently, air quality levels are not to exceed (or be projected to exceed within 24 hours) 75% of the NAAQS in order for a burn day to be in compliance with the same. In the S1009's language, "the program is difficult to manage because 75% of the current NAAQS for ozone is close to background ozone concentrations in rural Idaho." Hence, S1009 proposes to raise, "the ozone evaluation threshold from 75% to 90%." The initial rate will remain the same for the 2017 burn season, increasing on February 28, 2018, the expected date of the EPA's approval of the increase.
The subjects of air quality and ozone levels are very complex. Counter-intuitively, ozone levels in rural areas may often be higher than in urban ones, "because ozone levels are generally higher downwind of ozone precursor sources, at distances of hundreds or even thousands of kilometers..."(Jeannie Allen, writing for NASA's Earth Observatory here). Hence, what happens in our urban areas affects what can or does happen in our rural ones. In the case of S1009, the "can and what" is crop residue burning. The DEQ offers an excellent explanation of what crop burning is here and offers a link dedicated to daily air quality reports and forecasts here. The impact of ozone on human health is discussed in Allen's article, cited above, and also on the EPA's website here.
In the Spirit of Clean Air
From the AP: "Two years ago, lawmakers passed a transportation funding plan that raised vehicle registration fees and the gasoline tax by 7 cents. Electric and hybrid vehicles faced higher registration fees because lawmakers argued those owners don't pay as much at the pump." House bill 20 proposes to reduce the extra $75 registration fee to gasoline hybrid owners as, according to Rep. Steven Harris, these drivers "already pay the appropriate gas tax at the pump." Monies collected from these fees go toward maintaining Idaho's roads and bridges. Read source material here
H0004: It's Legit to Quit!
The Board of Pharmacy is proposing legislation through bill H0004 (01/17/2017 reported printed; referred to Health & Welfare) amending the practice of pharmacy in a way that will increase the public's access to tobacco cessation products "in certain scenarios." Under H0004, pharmacists will also be required to obtain advanced training and engage in certain protocols when prescribing or screening a patient for the appropriateness of tobacco cessation products.
In other tobacco related legislation, H0025 proposes to change language relating to tobacco permits, amending Idaho Code 63-2555. H0025 would simply use the word "permit" over "registration certificate" in the body of the code.
This is a good place to pause and remind readers that the IPHA supports tobacco cessation in the interest of the public's good health. Initiatives such as the Tobacco 21 Resolution receive the endorsement of the IPHA in moving toward healthier bodies and communities!
S1013
S1013 addresses a conflict issue between two statutes in the Idaho Code relating to the charging of juveniles with possession of marijuana, and proposes to, "help...avoid confusion in the system as a whole" by repealing section section 18-1502c of the law.
IPHA Bill Tracker
Bill No.
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Description
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Last Action
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S1003
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Nurse emeritus licenses; licensure renewal & reinstatement
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01/16/2017 Reported printed; referred to Commerce & HR
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S1004
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Board of Nursing member raise in compensation
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01/13/2017 Reported printed; referred to Health & Welfare
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S1009
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DEQ; crop residue burning
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01/19/2017 Reported Printed; referred to Health & Welfare
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S1013
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Marijuana/drug paraphernalia repeal
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|
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01/20/2017 Reported printed; referred to JR
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H002
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Pharmacists reciprocal licensing
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01/17/17 Reported printed; referred to Health & Welfare
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H003
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Pharma/tuberculin protein products
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01/17/2017 Reported printed; referred to Health & Welfare
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H004
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Pharmacists, tobacco cessation products
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01/17/2017 Reported printed; referred to Health & Welfare
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H005
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Controlled substances, opioids
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01/17/2017 Reported printed; referred to Health & Welfare
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H006
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Controlled substances
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01/17/2017 Reported printed; referred to Health & Welfare
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H007
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Massage therapists; change “establishment to school”
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01/17/2017 Reported printed; referred to Health & Welfare
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H008
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Massage therapists; institute criminal background checks
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01/17/2017 Reported printed; referred to Health & Welfare
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H0010
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Chiropractic practice; licensure
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01/17/2017 Reported printed; referred to Health & Welfare
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H0011
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Optometrists; licensure/provisions & revisions
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01/17/2017 Reported printed; referred to Health & Welfare
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H0020
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Vehicles; hybrid/plug-in fee reduction
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01/20/2017 Reported Printed and Referred to Transportation & Defense
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H0025
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Tobacco permits, terminology
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|
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01/20/2017 Reported Printed and Referred to Revenue & Taxation
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