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Health insurance exchange not quite dead yet

Health insurance exchange not quite dead yet

Wayne Hoffman
March 17, 2012
Wayne Hoffman
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March 17, 2012

“There’s a big difference between mostly dead and all dead,” said Miracle Max in the movie “The Princess Bride,” adding “Mostly dead is slightly alive.”

Idaho’s state health insurance exchange is mostly dead. But that’s not the same as all dead.

Reports that state lawmakers have given up on plans to create an Obamacare health insurance exchange are not entirely true; the legislators who support an insurance exchange are still working the issue and not too long ago sent a new draft of their proposal to colleagues for their evaluation.

Legislation to create an insurance exchange was introduced some time back by Boise Democrat Sue Chew. Her bill is not a version that is acceptable to the majority party Republicans, and so it probably won’t advance.

The supporters of the exchange concept now figure that they need to do three things to secure passage.

First, they’ve decided they need to stop calling their proposal a health insurance “exchange.” Instead, they’re calling it a health insurance “clearinghouse,” as if giving it a sporty new name will confuse us all into believing it’s something that it’s not. A duck is a duck is a duck. And a pig with a plastic bill and phony webbed feet is still a pig, no matter how many times you call it a duck.

Second, the supporters of the Obamacare exchange have written their proposal to prohibit the use of federal money in the formation of the exchange. The federal money no doubt ties the hands of the state, but it is not the only affliction that this idea has. The creation of a new government agency is simply offensive, and that is not helped by the prohibition against accepting federal aid.

Which brings me to the third stunning attempt to subdue opposition: The draft legislation says the health insurance “clearinghouse” is not a government agency. Forget the fact that this non-government agency will have the ability to levy and assess fees to keep the “clearinghouse” operational and will assume other trappings of government, including compliance with the state’s public records and open meetings law.

Still, as long as the Legislature declares this agency is not an agency, then it must not be.

While supporters of the health insurance exchange plot to get legislation that will pass House muster, a key vote in the next few days will serve as a harbinger. Rep. Bob Nonini of Coeur d’Alene has written a concurrent resolution urging private sector insurance companies to pony up the cash and the willpower to build their own insurance exchange. The resolution advocates free-market health care solutions and says the Patient Protection and Affordable Care Act has provided nothing more than a means to drive up health care costs and force the states to adopt federal programs at the expense of their sovereignty.

Nonini’s  resolution easily cleared the House Business Committee on a party-line vote. If his proposal wins with the rest of the House, the health insurance exchange debate in Idaho will most certainly be dead. But it’s not yet, and legislation has a way of springing back to life when you least expect it.

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