In the aftermath of the Idaho Senate last week passing Gov. Butch Otter’s insurance exchange legislation, attention has now turned to the Idaho House. And two House members, one a veteran who is in leadership and another who is a freshman, are speaking out strongly against the legislation.
“This is the vote of my life,” first-term Rep. Janet Trujillo, R-Idaho Falls, told IdahoReporter.com. “I didn’t know I would face this in my first few weeks as a representative, but here I am, and I have to do the right thing.”
Both Trujillo, and House Majority Leader Mike Moyle, R-Star, oppose the insurance exchange agenda, and they share some of the same concerns about it.
“Senate Bill 1042 (the governor’s insurance exchange bill) sets up a quasi-governmental entity that isn’t subject to any oversight by the Legislature at all,” Moyle told IdahoReporter.com. “I’m not sure how we can call this a ‘state-based exchange’ given that the plan only allows for the governor to exercise oversight, and in any event, a state insurance exchange will ultimately be beholden to the secretary of HHS (United States Department of Health and Human Services in Washington, D.C.). I’m concerned that if this passes, Idaho will come to regret it.”
To demonstrate the link between an Idaho insurance exchange and the controlling forces of the federal government, Moyle and Trujillo both point to the “blueprint” document for an insurance exchange that was crafted by the Idaho Department of Insurance back in December of 2012. In Section 1.2 of this document (the full text is still linked on the website of the Idaho Department of Insurance), it is stipulated that an Idaho insurance exchange will do the following:
(1) carry out the required functions of an Exchange; 2) meet the information reporting requirements associated with premium tax credits; 3) serve the entire geographic area of the State; and 4) meet the standards for a State-based health insurance exchange set by the U.S. Department of Health and Human Services (HHS) exchange regulations as outlined in ACA 1311(d) and 45 CFR 155.110.
The fact that the Idaho insurance exchange plan is intended to be compliant with Section 1311 of the ACA (Affordable Care Act, commonly referred to as the Obamacare law) bothers Moyle and Trujillo for multiple reasons.
For one, Trujillo notes concerns about the costs of starting and operating an exchange, and notes that Section 1311 poses significant uncertainty on the matter.
On Feb. 5, Otter’s chief of staff, David Hensley, told the Senate Commerce and Human Resources Committee that the governor estimates the costs of creating an insurance exchange to be approximately $20 million, and that there are “federal funds available” to cover these costs. On Feb. 18, Bill Deal, director of the Idaho Department of Insurance, reiterated this claim to the Joint Finance-Appropriations Committee.
Yet Trujillo points out that in Section 1311 of the Obamacare law, it is stipulated that funds for insurance exchanges have to be appropriated by Congress, and appropriated to the secretary of Health and Human Services, and the HHS secretary will then award those funds to the individual states at his or her discretion.
Moreover, Trujillo points out that Section 1311 of the Obamacare law specifically states that “For each fiscal year the Secretary shall determine the total amount that the Secretary will make available to each State for grants under this subsection.”
“We’re being asked to sign on to a plan, but the costs to Idaho are unknown,” Trujillo tells IdahoReporter.com. “We don’t know what kind of funding the Congress will appropriate for this. We’re at the HHS secretary’s whim.”
Trujillo finds other portions of Section 1311 to be even more disturbing. For example, the portion of the section labeled “subsection I” requires a state insurance exchange to “transfer to the Secretary of the Treasury” a list of names, and taxpayer ID numbers, of individuals who participate in the exchange.
Trujillo also notes that at the end of Section 1311, labeled “subsection K,” the Obamacare law stipulates that, “An exchange may not establish rules that conflict with or prevent the application of regulations promulgated by the Secretary (HHS Secretary) under this subtitle.”
“It’s quite clear what an Idaho insurance exchange would do,” Trujillo says. “From the start, the plan has been to create an entity in Idaho that complies with and is beholden to the federal government, and the federal government says that our exchange can’t conflict with their mandates. It is naïve to say that a state insurance exchange will be ‘just a website,’ because it will be an entity that is gathering information about Idahoans and sending it to the Department of the Treasury and the Department of Health and Human Services. We will abandon our sovereignty as Idahoans if we do this.”
So, what might the House of Representatives do with Senate Bill 1042? “There is a lot of interest in amending it, but I don’t know if the speaker (Speaker of the House Scott Bedke, R-Oakley) will allow that,” Moyle told IdahoReporter.com.
Trujillo, however, says that she believes there will be an attempt to reconcile Senate Bill 1042 with House Bill 179, a different version of an insurance exchange bill.
IdahoReporter.com asked Trujillo why she has taken a position on the insurance exchange agenda that is so different from many of her fellow Republican freshman in the House, especially the so-called “gang of 16” who pledged to support it.
“Because I read the documents,” she replied. “I read the Obamacare law, and Idaho’s exchange blueprint, but I think there are a lot of people here who aren’t reading and are simply repeating what they’ve been told. There are also a lot of people here who are looking out for the interests of the insurance industry, and the exchange will be good for insurance companies, at least for a while. But I was elected to serve all my constituents, and that’s why I’ve got to say no to this.”