Sen. Steve Thayn, R-Emmett, is preparing legislation to modify how Idaho cares for its very poor residents.

Eventually, he said, he hopes his plan could entice the state to drop Medicaid and opt for an entirely new—and cheaper—system of care.

Thayn, a freshman senator who served in the Idaho House before moving to the Capitol’s upper chamber, plans to introduce a bill in the 2014 legislative session to eliminate the state’s catastrophic health care fund, which covers medical bills for many Idahoans who lack health insurance. Thayn proposes to use the money to fund community health centers around the state. The health centers, he explained, would operate on a charity care model, an operation that utilizes volunteers and monetary donations to provide care for some of the poorest Idahoans.

Funneling the state’s indigent care money to the community health clinics could mean a substantial cash infusion for the centers, which occasionally struggle to pay their bills and keep up with demand.

Last year, Idaho lawmakers budgeted more than $34 million for the catastrophic fund. This year, Idaho Gov. Butch Otter requested just more than $36 million for the account, which covers indigent health costs after counties pay the first $11,000 on each case.

If Thayn gets his way, lawmakers will soon send that money to clinics to set up shop, buy equipment and purchase medication.

Several lawmakers and powerful interest groups, including the Idaho Association of Commerce and Industry, want to expand the state’s Medicaid system as allowed under Obamacare, but Thayn told IdahoReporter.com that’d take the state down the wrong path.

“We shouldn’t expand Medicaid,” he said. “We should replace it.”

Expansion proponents note that the state could easily eliminate its catastrophic spending by swelling Medicaid because it would cover those without insurance. Expansion, they say, would ease the burden on state government.

Critics of expansion point out that swelling Medicaid only means shifting much of the burden to the federal government, which is deeply in debt and borrows trillions to cover its own costs.

Otter announced during his State of the State address Monday that he will not push Medicaid expansion—at least for now. The governor worried that expanding the program and accepting more federal dollars could eventually leave the state on the hook for bills it won’t be able to pay.

Thayn, while taking a pragmatic approach to the issue, also sticks to his limited-government principles regarding more government-run health care. “The only thing they have is growing government,” he said. “We have to change the discussion.”

And that’s exactly what he intends to do in 2014. He’s actively searching out votes to secure passage of his bill.

Sen. Marv Hagedorn, R-Meridian, told IdahoReporter.com that Thayn approached him about several medical reform concepts, including the charity care plan. Hagedorn, also a first-term senator who served in the Idaho House, said he hasn’t bought in to Thayn’s idea just yet.

“I think the idea is good,” Hagedorn said, but added that the plan needs serious vetting before moving forward. He is concerned if charity-based clinics can treat “extreme care” patients, including the hundreds of Idahoans who now use the catastrophic program to cover health costs.

“I suspect the majority of cases are extreme care,” Hagedorn said.

Even if he isn’t yet fully on board with the Thayn plan, Hagedorn believes Idaho legislators must use the 2014 legislative session to position the state for the collapse of the federal health reform initiative.

“We all know Obamacare is going to collapse,” Hagedorn said. “We need to position ourselves to ensure that people have good health care.”

And that’s the positioning Thayn believes he can do with his charity care system. Thayn also recognized that Obamacare, rife with problems from technology to law structure could fail, which might lead policymakers to call for a single-payer health care system, which he wants to prevent.

“The single-payer system is all that would be on peoples’ mind at that point,” Thayn said. “And we have to show everyone that there is something different out there. It’s absolutely critical.”