The state isn’t going to put forth the funds to build a health insurance exchange, but that doesn’t mean lawmakers don’t want one created.
The Idaho House voiced its support of the idea by passing a nonbinding resolution to encourage Gem State health insurance carriers to build their own cooperative exchange program. The measure passed 49-13.
Only Republicans voted for it, but Democrats were joined by GOP Reps. Maxine Bell, R-Jerome, Fred Wood, R-Burley, Marc Gibbs, R-Grace, and Leon Smith, R-Twin Falls, in opposition to the bill.
Rep. Bob Nonini, R-Coeur d’Alene, backer of the nonbinding resolution, said because private health carriers have shown considerable interest in establishing an exchange, he wanted the Legislature to go on record asking them to come up with their own solution.
A private system, Nonini contended, would have a better chance to bring down health care costs because it wouldn’t be burdened by government oversight, fees and taxes. “I don’t see how any of those things make health care more affordable,” Nonini said of the taxes imposed on health carriers to operate a state exchange.
Nonini, who labeled himself “an outspoken opponent of a health care exchange” built with federal or state money, says that health carriers are properly equipped to build their own program, possibly dipping into reserves to do so. The Coeur d’Alene Republican said his measure showed the state’s “enthusiastic, but not monetary” support of the idea.
The debate has taken many directions since Gov. Butch Otter applied for $20 million in federal money last fall to build a state exchange. Otter’s Health Care Task Force outlined and approved a structural foundation for a exchange days prior to the 2012 legislative session, but legislative leaders never could garner enough support to assure its passage.
Then, Rep. Fred Wood, R-Burley, and Sen. Dean Cameron, R-Rupert, released their own draft plan of a state exchange that would have cost the state about $5 million, but it wouldn’t have been federally compliant.
The Wood/Cameron plan, too, couldn’t gain traction in the Statehouse.
Part of the driving force behind the exchange, at least for health insurance carriers, is the hefty subsidies that would come along with a federally certified program. Idaho families earning up to $88,000 annually would be eligible for subsidies and the federal government would pump millions straight into health carrier coffers.
But neither the Wood/Cameron plan nor a private health exchange would qualify for the federal insurance subsidies. Along with concerns over a state exchange’s impact on insurance prices, the program is also opposed for ideological purposes.
It is unclear what happens if Idaho opts not to establish a state exchange program. It is likely the federal government would then implement its own system using Idaho’s health carriers, but critics of that move argue that a technicality in federal law would prevent that from happening.
The federal government has set exchange certification for Jan. 1, 2013, but states have until Oct. 1 next year to bring their programs to functionality.
Several states, including Kansas, New Hampshire and Florida, have rejected the federal call for exchanges. Kansas Gov. Sam Brownback returned the federal money allotted to his state for exchange implementation.
The measure now heads to a Senate committee for consideration.
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