Idaho Department of Insurance Director Bill Deal said Idaho is one of 12 states that have had no legislative action to date to establish a health insurance exchange. Meanwhile, 13 states have enacted such legislation, including Washington, Oregon, Nevada, Utah, California, Colorado and California. There's a January 2014 deadline to have the exchange up and running and certified, Deal said. “If Idaho does not have that exchange in place, then we … are going to be provided that exchange coverage through the federal government, which many of us don't think that's the best plan,” he told the Legislature's Health Care Task Force this morning.
As far as how much it'll cost to set up an exchange, Deal said the state of Washington estimates it'll cost $99 million from 2011 to 2013; Kansas estimates $62 million over two years; and Wisconsin estimates $49.5 million from 2010 to 2013. “If Idaho does not demonstrate that it is … ready to run an exchange, the federal government will impose and run an exchange in Idaho,” Deal said. “My personal view of this … it's going to be very disruptive to the Idaho marketplace and particularly with our domestic insurance companies and our agents, and that's a big issue. And also, the other part that is just as concerning to me, that the regulation of the health insurance industry in Idaho will not be state-based but without question, the federal government's going to dictate the policies that are followed here in Idaho with health insurance.”
He said, “We do have some options. … We can submit that grant application. … It does not lock Idaho in. … Securing the grant allows Idaho time to make the decision, we have the money, we can continue to move forward. … If something comes along, we can take that exit strategy. … This gives us time to wait for the lawmakers to decide options for the Idaho exchange.” He added, “In my view, time is the enemy.”