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House defeats 'Any Willing Provider' expansion

House defeats 'Any Willing Provider' expansion

Dustin Hurst
March 3, 2010
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March 3, 2010

People are often turned off to politics because they believe the proceedings are boring.  Members of the Idaho House proved otherwise during a lively two-hour debate about Rep. Bob Nonini's, R-Coeur D'Alene, bill designed to require insurance companies to contract with any licensed medical professional that a company's customer wants to work with.

In his speech to lawmakers, Nonini said his bill will help give citizens of Idaho more choice and will increase competition in the medical industry, thereby driving down overall costs of health care.  The relationship between a doctor and a patient is of utmost importance and should be guarded by the state, argued Nonini.

Rep. Raul Labrador, R-Eagle, questioned those who argued against the bill on the grounds that it would drive up costs, including Rep. Elfreda Higgins, D-Garden City, and Rep. Tom Trail, R-Moscow.  Labrador asked those representatives to show evidence that including more doctors in networks would actually raise costs, because he believes competition drives down costs.

"More competition usually brings down the cost of services … it doesn’t bring it up," said Labrador. "That is contrary to any economics book I have ever read."

"We may have been reading different economics books then," said Higgins.

Not all legislators were in agreement with Nonini and Labrador.  Rep. Fred Wood, R-Burley, a physician himself, said the best way to prevent massive insurance rate increases is to allow insurance providers to effectively manage their own networks.

On Labrador's claims about competition, Wood said "the myth of competition is purely that - a myth."  Wood continued to urge lawmakers to vote against the bill and allow insurance companies the power to coordinate health networks and, in an interesting twist for a largely Republican Legislature, warned that approval of the bill would lead to more government regulation by forcing insurance companies to contract with doctors they don't want to contract with.

Another doctor in the House, Minority Leader John Rusche, D-Lewiston, echoed Wood's sentiments.  Rusche said that he, like Wood, believes that provider networks are the best tool in keeping health care costs low.  Rusche said the point of networks is to be able to negotiate and work with a certain set of doctors at agreed-upon rates.

"Networks offer better savings," said Rusche.

Fellow Democrat, Rep. Branden Durst, D-Boise, said the bill is about the free market and its role in the medical industry.

"I think we all believe the free market works," said Durst.  He called on lawmakers to let the free market correct itself by supporting the bill and allowing more doctors into the system.

Rep. Steven Thayn, R-Emmet, questioned Rusche on the bill's actual impact on health care costs.

"Does the bill force insurance providers to pay more those outside the network more than those inside the network?" said Thayn.  Rusche replied that insurances providers would not be forced to pay higher rates to doctors outside the network.  Thayn then stood in opposition to the bill, saying that the measure would stifle innovation and efficiency in the medical field.

"Passage of this bill would indeed not stimulate innovation and competition," said Thayn.

After more than two hours of debate on the bill, Nonini was allowed closing remarks before the vote.  Nonini likened those in the House who raised concerns about higher insurance rates to someone yelling "fire" in a crowded theater.  Rep. Grant Burgoyne, D-Boise, objected to the remarks, saying that all the concerns raised by legislators in opposition to the bill had been made in "good faith."  House Speaker Lawrence Denney, R-Midvale, stopped short of asking Nonini to retract his comments, but did instruct him to "tone it down."  Nonini finished by saying that the bill would guarantee patient access to a doctor of choice and would help keep rates low.

Following his remarks, House members voted on the bill, defeating it 31-39.

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