After Butch Otter was abducted by aliens and replaced with a replicant (estimated to have occurred sometime around 2008), he’s been increasingly creative with the ways in which he injects government into our lives. This is especially true in healthcare. Five years ago, the Otter replicant convinced the Idaho Legislature to start a state health insurance exchange. This year, Otter looks add thousands of Idahoans to Medicaid and give even more people Obamacare insurance subsidies.

Among the reasons for lawmakers to declare Otter’s proposal dead on arrival, this newest Ottercare plan would:

• Take people off private insurance and put them on Medicaid, a poorly-run, expensive program that will limit patient choice and access to care.
• Increase Idaho’s reliance on federal money and subject the state to greater federal oversight.
• Make Idahoans dependent on Obamacare insurance subsidies, further cementing the ill-conceived law in place.
• Bailout Big Insurance at great cost to taxpayers, projected to be $22 million in the first year alone.

The above negatives aside, the Otter administration announced Friday it is working to allow the sale of insurance plans that don’t include all of Obamacare’s required 10 essential health benefits. This will help lower the cost of insurance and provide consumers with more choice. The Idaho Freedom Foundation developed and pitched this idea last July.

All in all, legislators can do better than the new, poorly conceived and counterproductive Ottercare. Legislators can truly help Idahoans who are struggling to pay for healthcare. Among other things, legislators could:

• Allow the buying and selling of health insurance across state lines. This would increase greater competition and thus consumer choice, ultimately leading to lower costs and better service.
• Allow Idaho insurance companies to offer non-Obamacare compliant health insurance plans. They could also remove other insurance and medical regulations that increase costs.
• Make it easier for doctors to provide free or reduced-cost care to patients who have limited means. This can be done several ways, including the expansion of charity-care medical liability protection to doctors who offer care in their offices or clinics. Legislators could also direct the State Board of Medicine to reduce the number of legally-required continuing medical education hours for providers who provide care to people of limited means.
• Tie property and sales tax exemptions for charity hospitals to price transparency and cost containment. If a hospital receives government tax breaks, a patient should be able to tell how much the hospital's services cost.
• Reform Medicaid so that patients have more choices as well as more ownership for their well-being. Direct primary care and other non-traditional medical care providers can cost less and offer better care, and patients could be held accountable with work requirements, copayments and other tools to have “skin in the game” instead of “free” medical care.
• Audit Medicaid to ensure that enrolled participants still meet program qualifications. As a result of a recent audit, neighboring Oregon determined that many ineligible people were still receiving Medicaid.
• Leverage the network of non-profit organizations so that people can get the help they need without requiring aid from the government. There are many charities whose singular mission is to help lift people out of poverty and solve problems for people in need. Instead of just signing people up to be part of a government program, the goal of state government should be to reduce the number of people dependent on a program, subsidy, or bureaucracy.  
• As a safer alternative to many prescription opioids, decriminalize cannabis and non-psychoactive cannabis extracts, so that people can get the pain relief they need at far less cost and in far safer form.  

For many years, Idaho’s government, like those in other states, has bought into the notion that just one more government program, just one more regulation, or one more law would help people with their healthcare costs. This thinking hasn’t helped. Ever. Legislators need to again say no to Ottercare and free the marketplace so that both taxpayers and medical patients are helped during the 2018 legislative session.