Oct. 27--BOISE -- Idaho Gov. Butch Otter's health insurance exchange working group has voted overwhelmingly in favor of a state-based health insurance exchange, calling for a private nonprofit group set up by the state to run it.
The recommendation now goes to Otter, who must notify the federal government of which way the state will go by Nov. 16. If the state does nothing, under the Affordable Care Act it will get a federally run health insurance exchange and lose state regulatory control over its health insurance industry.
Only two members of the 13-member panel dissented in the decision: Rep. Lynn Luker, R-Boise, and political activist Wayne Hoffman.
Hoffman compared the state's relationship with the federal government to "the relationship of an abuser to a spouse. We keep getting beat up by the federal government and we keep running back to the federal government, and we have done it time and time again."
He said, "I think the best interest of the state is to continue to resist this constitutionally dubious federal law. ... The only way you're going to get the federal government, Congress and the executive branch to reconsider the law is just to resist its implementation."
Kevin Settles, owner of Bardenay restaurants, countered, "We need to get past arguing the legality of the law. The Supreme Court settled the issue. We can make something good out of this. ... With the state-based nonprofit exchange, we can make it reflect Idaho." He noted that Idaho's current health insurance premiums are among the lowest in the nation, saying an Idaho exchange can be "lean and mean."
Idaho lawmakers took no action on a health insurance exchange in their 2012 session, betting instead that the national health care reform law requiring exchanges would be overturned by the U.S. Supreme Court. The law was upheld in June.
Rep. John Rusche, D-Lewiston, said opting for a federal exchange would mean much higher health insurance costs for Idahoans, "charging the citizens of the state of Idaho$120 million more for basically the same insurance they're getting now."
Panel member John Watts said, "I just don't know why we'd want the federal government to control absolutely everything if we have an option to avoid that."
There have been conflicting opinions on whether Idaho even has time to complete a state-designed exchange by Jan. 1, 2014, as required by the federal law. On Oct. 9, for instance, experts hired by the state said Idaho's only option was to partner with the federal government on a hybrid exchange, as time had run out on going it alone. On Friday, however, another consultant said Idaho still had time.
Idaho can build a state-based exchange, using some $30 million in aid from the federal government, "if you aggressively go after it," said Brett Graham, of Leavitt Partners in Utah.
The Associated Press contributed to this report.
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