The Supreme Court of Idaho has interpreted that the Medical Indigency Act's legislative purpose has two components: "to provide indigents with medical care and to allow hospitals to obtain compensation for services rendered to indigents." (23) However, a hospital can only receive compensation for medical care if a board of county commissioners determines that a patient is
medically indigent within the meaning of Idaho Code section 31-3502(15).
Poorer States declined or were slow to take up the
medically indigent option or raise the income levels for Medicaid eligibility.
The results of this hospital community benefits and free care programs study show that steps are needed to improve access to medical care for individuals who are vulnerable and
medically indigent. Free care is an important safety net that allows low-income, uninsured people to receive medical care.
Of the 7 practices, 4 are family medicine residency sites, 2 are federally-funded community health centers, and 1 is a clinic for the
medically indigent. The provider mix in CaReNet includes 56% residents (residents average approximately 3 half-day clinics weekly), 21% full-time clinical faculty, 7% private physicians, and 15% other providers (nurse practitioners, physician assistants, and so forth).
The GAMP program was repositioned to become a purchaser within the market for services needed by
medically indigent individuals.
This lack of dental service coverage under many insurance plans, and the difficulty of accessing dental care for uninsured, underinsured, and
medically indigent groups, make dental sealants hard to obtain.[6]
When medical bills exceeded a state-determined percentage of monthly income, such bills could, at state option, be covered under a '
medically indigent' provision.
That debate is focused on the serious problems of the elderly; ignored are the younger-aged "
medically indigent"-the many others who cannot afford the medicines they need, whether they are employed or unemployed, low- or middle-income, with poor insurance or no insurance.
It took John Kitzhaber, a physician-politician, to point out to a disbelieving nation that as an office holder he was responsible both for those covered and for those not covered, and he had to consider not only Coby Howard's need for a transplant, but also the state's duty to all of the
medically indigent. He was not arguing for a two-tiered system; he was trying to maximize limited public funds in the only health care program for the
medically indigent that the state had legislated.
As the Clinton reform effort gathered steam in 1993, one worry among those of us who favor a national approach to health care was that the middle class would be well-served by badly needed insurance reforms, while the poor and the
medically indigent would end up ignored.
The state Medicaid program has been expanded to cover all
medically indigent people.(11) Legislatures vote on and make law those conditions and procedures that will not be reimbursed when funds drop to certain levels.(9)
As the numbers of poor and
medically indigent grow, stresed hospitals may be be forced to restrict the number of poor and Medicaid recipient they admit -- or they may have to close their doors altogether, said the report.