Lawmakers escalate a high-stakes war on a medical school partnership

Analysis

Idaho ranks No. 50 in the nation for physicians per capita.

Idaho’s standing can’t get any worse. Its doctor shortage easily could.

Yet three well-placed legislators want to pull the plug on Idaho’s oldest — and largest — medical school partnership. It’s a risk. And the culmination of years of growing tension between Idaho lawmakers and the University of Washington’s medical school.

“They’ve become political, in my opinion, and that’s not cool,” said House Speaker Mike Moyle, R-Star, a co-sponsor of the bill. “We don’t need that. Teach how to be good doctors. Get us some good folks here in Idaho. We need them, but we don’t need your politics.”

House Bill 176 would end the University of Idaho’s relationship with the UW’s med school, a partnership that began in 1972. Each year, 40 Idaho students get a state-subsidized medical school seat through the WWAMI program — named for the member states of Washington, Wyoming, Alaska, Montana and Idaho. (Idaho’s departure would, theoretically, make this the WWAM program. If “Careless Whisper” is now your earworm of the day, enjoy.)

Gratuitous ‘80s pop references aside, the rift over WWAMI is serious — and multifaceted:

Capacity. For years, Idaho has wanted to send more students to WWAMI. The 2022 Legislature passed a resolution encouraging the State Board of Education to secure an additional 10 WWAMI seats per year. It hasn’t happened.

It isn’t for lack of applicants; 150 to 160 students apply for WWAMI seats each year, said Suzanne Allen, a Boise family physician who is also the UW’s medical school’s vice dean for academic, rural and regional affairs. The problem is a shortage of clinical placements. The UW struggles to find placements for 40 Idaho students a year, in Idaho or the other WWAMI states, Allen said.

Rate of return. In 2022, Moyle pushed a separate bill requiring WWAMI graduates to work in Idaho for four years, or refund the state money that subsidized their studies. The bill became law — but not before then-Lt. Gov. Janice McGeachin broke a rare tie in the Senate, sending the bill to Gov. Brad Little.

Moyle argued then — and argues now — that Idaho should get a return on the $7 million-plus that it puts into WWAMI. It’s too soon to tell whether Moyle’s law will make a difference, since it first went into effect for fall 2023. But Allen says Idaho is getting a 72% “rate of return” on WWAMI; that is, for every 100 students Idaho has subsidized, Idaho has attracted 72 grads from one of the program’s five member states.

Abortion. Under Idaho’s restrictive anti-abortion law, no taxpayer dollars can go toward abortion classes. The UW isn’t using Idaho tax dollars for its elective courses in abortion, Allen said, and it has audits to prove it. The UW hasn’t yet signed a formal and required contract to that effect. “We’re working on that process,” Allen said Wednesday. “There are lots of people who look at every contract before it gets signed.”

Introduced in a House committee last week, HB 176 would gradually sever Idaho’s relationship with WWAMI. Current Idaho students are grandfathered, and will be able to continue their studies. Idaho would continue subsidizing WWAMI slots through 2026-27.

Moyle says time is on Idaho’s side. “It’s a two-year deal,” Moyle told Idaho Education News Wednesday. “So hopefully between now and then, we can start finding other places to make sure we have at least the 40 (seats), and hopefully more than we have in Washington right now.”

HB 176 doesn’t say where Idaho will find its 40 replacement medical school slots, but it narrows the field considerably. It directs the State Board to find two partners by 2027-28 — in Idaho, or in “adjacent states located wholly within the Mountain Time Zone.” That is, in other words, Montana, Wyoming and Utah.

So, who could be in the running?

ICOM. The nine-year-old Idaho College of Osteopathic Medicine is the lone in-state candidate. The private college, located adjacent to Idaho State University’s Meridian campus, has a deep affiliation and multiple agreements with Idaho State.

Idaho does not subsidize medical school seats at ICOM, at least not yet. But if HB 176 passes, that could be on the table this session, Moyle said.

In a House committee hearing Tuesday, ICOM President Tracy Farnsworth didn’t talk about partnering on medical school seats. But he made a thinly veiled sales pitch. “(ICOM) is for real. It’s here to stay. It’s not like back in 2016, when It was a risky thing. It was a startup.”

University of Utah. Idaho already has a partnership with the University of Utah, a $3 million agreement subsidizing 10 medical school seats a year.

With WWAMI in jeopardy, the U of I is looking at Utah as a possible fallback. In a January memorandum of understanding, obtained by EdNews, the U of I and the University of Utah agreed to collaborate on “a regional campus model … that guarantees Idaho residents access to a medical school.”

Other options. Moyle says Idaho could have other regional options — including Brigham Young University, which is launching a medical school.

HB 176 isn’t a done deal. Moyle says he talked with the U of I and Idaho State on his bill, but he expects pushback from the hospitals.

The Idaho Hospital Association hasn’t taken a formal position, but it has concerns. “It’s a concept that I don’t think has been fully vetted,” CEO Brian Whitlock said Thursday. “Our encouragement is to slow the train down.”

And Allen says she plans to reach out to lawmakers about the UW’s programs. “We want to see Idaho WWAMI continue, and we hope that that’s where we end up.”

But Moyle tends to get a lot of what he wants, especially in the waning days of a legislative session. He has a pair of high-profile co-sponsors: Rep. Dustin Manwaring, R-Pocatello, a member of the Joint Finance-Appropriations Committee; and Sen. Dave Lent, R-Idaho Falls, the chair of the Senate Education Committee.

“It’s OK to look elsewhere,” Lent said this week. “It’s OK to look (at) places that may serve us better.”

But HB 176 isn’t just about looking. It would make a wholesale change in medical education in Idaho. It’s one of the most important higher education decisions before the Legislature this year.

Kevin Richert writes a weekly analysis on education policy and education politics. Look for his stories each Thursday on idahoednews.org.