After nearly four years of national debate over federal health care reform and a good two years or more of debate on the issue in Idaho, Tuesday the first proposal to legislatively create a state health insurance exchange will be revealed.
IdahoReporter.com has obtained a copy of a draft of the legislation that is set to be introduced Tuesday. The draft, with references to the founding ideals of the nation and the Constitution, stipulates that the operating details of a state insurance exchange would be determined by the Idaho Department of Insurance, with minimal oversight from elected members of the Legislature. How closely the official legislation to be revealed Tuesday afternoon will match the draft will not be known until the committee hearing.
A vocal opponent of creating an exchange is Wayne Hoffman, executive director of the Idaho Freedom Foundation. The governor’s draft has done nothing to sway him toward acceptance of a state-based health care exchange. Says Hoffman: "Simply adding words and sentences extolling the virtues of the Constitution and state sovereignty do not automatically make the legislation favor either. The draft legislation I saw creates a new government agency with little real government oversight, and does little to promote the principles that a free society expects or demands."
A different view comes from Sen. Dean Cameron, R-Rupert. “An exchange is a website that provides information about insurance plans and links to their providers,” says Cameron. “Nothing more and nothing less.” Cameron sits on the Senate Commerce and Human Resources Committee and is co-chair of the Joint Finance-Appropriations Committee (JFAC).
He and his fellow Senate committee members will be the first to hear specifically what Gov. Butch Otter has in mind to create a state-based insurance exchange. Otter’s chief of staff, David Hensley, is scheduled to present the plan before the committee.
After the U.S. Supreme Court upheld large portions of the federal Affordable Care Act, commonly referred to as Obamacare, each of the 50 states were faced with a federal mandate requiring them to either A) set up a state-based exchange; B) allow the federal government to do it; or C) pursue a “hybrid” approach to an exchange with both state and federal resources.
In July of 2012, Otter assembled an advisory committee that overwhelmingly recommended a state-based exchange, and in December Otter announced that he will follow that recommendation.
“I look at this differently than many others do,” said Rep. Tom Loertscher, R-Iona. “I’m asking, would we be talking about establishing an insurance exchange if we didn’t have to? A state exchange is going to have to comply with what the feds tell us, so we could potentially be looking at a federal program that is administered by our state.”
Despite the mandates of the federal law, some legislators reject the notion that Idaho must have some sort of health insurance exchange, and would prefer that Idaho abandon the pursuit altogether.
Sen. Russ Fulcher, R-Meridian, is one of them, and notes that “it’s time for Idaho to say no to the feds.” Fulcher adds that “The federal government doesn’t have the money, and frankly, I don’t think anybody in Washington has the intestinal fortitude to build 50 separate insurance exchanges and force them on to the American people. If we tell the feds that we are not building any exchange, then in all likelihood there won’t be one.”
Cameron, however, disagrees. “I simply don’t believe that the federal government, certainly not the Obama administration, will sit by and do nothing, and let us do nothing.” Cameron believes the best option is for Idaho to build a state-based exchange, noting that “If we don’t, we’ll have Washington building our exchange at a much higher cost, and requiring us to pay for abortion coverage and other things that many Idahoans won’t want.”
“I look forward to a lively discussion on the merits of Idaho adopting a state exchange,” said Sen. Branden Durst, D-Boise. Durst has previously noted that his support of the governor’s exchange proposal is not to be taken for granted. He told IdahoReporter.com that “as to what Gov. Otter needs to do earn my support, I’ll just say that a discussion with me directly would be a good place to start.”
Note: IdahoReporter.com is published by the Idaho Freedom Foundation.