One early hurdle for Idaho lawmakers in 2010 will be finding millions of dollars for the state’s childhood immunization program. Funding is set to run out at the end of January, though lawmakers working closely on the issue say temporary money should be found soon and a more permanent source—likely insurance companies—should be in place by July.
Idaho has some of the lowest immunization rates in the country, and the uncertainty over the vaccine funding is worrying some doctors.
“We’re working on it,” said Rep. Gary Collins, R-Nampa, one of the leaders of a task force of lawmakers trying to find funding for immunizations. Collins said he’s confident that lawmakers will find both short- and long-term money, but said there’s nothing concrete yet. The health care task force has held several meetings this year with doctors and representatives from insurance companies.
“We think we’re close to a compromise,” said Sen. Dean Cameron, R-Rupert, another task force leader. Cameron said the long-term source of money will likely be an assessment that insurance companies agree to pay for vaccines.
One doctor who gives vaccines to kids say physicians will need a plan from Idaho legislators by mid-January so they can make purchasing decisions on vaccines. Dr. Tom Patterson said further delays could lead to further drops in Idaho’s low childhood immunization rates. Patterson is a pediatrician in Nampa who leads the Idaho Immunization Coalition, a nascent advocacy group promoting immunization.
“When you’re last in the nation, the last thing you want to do is pull the purse strings,” Patterson said.
Two sources of money pay for vaccines in Idaho, which is run by the Department of Health and Welfare’s Idaho Immunization Program. The Vaccines for Children program uses federal dollars to pay for immunizations for children without insurance or on Medicaid, and kids who are Native American or have insurance that doesn’t cover vaccines. The state pays for vaccines for children not eligible for VFC immunizations.
That state funding is set to expire January 31st. The current search for more money for non-VFC vaccines replays a similar debate last spring when Gov. Butch Otter ordered zeroing out funding for the immunization program. The result was a one-month gap last July without state funding before Otter gave $2.1 million from a state rainy day fund to the immunization program.
Patterson said that gap in July without state money hurt his medical practice. Normally, the state reimburses doctors for vaccine purchases. The company Patterson works for, Salzer Medical Group, bought their own stock of vaccines July, but couldn’t use some of that supply when the state program came back in August.
“(Doctors) were left with vaccine sitting in a fridge,” Patterson said. “The burden fell to the provider to have a separate stock.” Doctors had to keep separate supplies of vaccines—one pool for children on VFC, and one for children with some kind of insurance.
“It turned out to be sort of a mess,” Cameron said about two-pool system. He said he got complaints from people in his district who had to pay more for vaccinations. “People were understandably upset.”
Patterson said repeating the gap in vaccine payments in February could be too much for some doctors. “I’m afraid that there will be providers that will just jump out of the immunization program altogether,” he said. If that happened, families in more remote areas of the state would have to travel farther to find providers still administering vaccines.
The likely source for permanent money for the vaccine program will be assessments paid by insurance companies that will go to a state pool of money for buying vaccines. Pooling that money would give the state a lower price for vaccines, thanks to a program run by the Center for Disease Control and Prevention. New Hampshire follows a similar fee-and-pooling system to buy immunizations.
“The insurance companies should be paying for these vaccines,” Cameron said. “An assessment is a much better deal for everybody.”
Cameron said that assessment will likely be between 25 and 50 cents per insured member per month or $3 to $6 a year. Idaho already runs an assessment on insurance companies for the High Risk Insurance Pool. Cameron said the high risk pool is a likely source for short-term funding for vaccines until a permanent immunization pool could start in July.
It’s difficult to predict if switching to an insurance-backed immunization program will lead to significant gains in Idaho’s immunization rate. The Gem State ranks at or near the bottom in the most recent federal survey of immunization rates for children under 3. All of Idaho’s neighboring states are also below the national average, though Oregon and Washington are close to it.
““When you’re last in the nation it’s really embarrassing,” Patterson said.
“It’s worse than a number of other third world countries,” Cameron said. “Obviously that’s something that’s very concerning.”
The health care task force will meet on January 13 to tackle the problem of funding the vaccination program.