State Insurance Director Bill Deal said the proposed health insurance exchange legislation would set up a "state-operated, market-driven health insurance exchange." Part of what that means has to do with a Dec. 16 bulletin from HHS that said states can decide the "benchmark plan" or minimum level of benefits required in any plan to be sold on their exchange, though they'd still have to meet 10 general criteria listed in the federal law for essential benefits. If states don't set up their own exchanges and the federal government steps in, it would make that decision for the state, even to the point of specifying which insurers could sell plans on the exchange.

Tom Donovan, deputy insurance director, said the bulletin makes clear that states can choose to let the market drive their benchmark plans, essentially allowing any legally qualified insurer to sell its plan on the Idaho exchange. That's the approach the Idaho legislation takes.