Sen. Dean Cameron, R-Rupert, questioned conservative activist Wayne Hoffman about the state’s legal position if it took no action to set up a state-based health insurance exchange and yielded to a federally run exchange. “A good example of that,” Cameron said, “(is) there’s a whole issue about whether termination of pregnancy is covered or shall be covered. Under a state exchange, the law specifically says the state can exclude it. We have taken action two years ago that says we can exclude it. But under a federal exchange, that would be essentially forced upon us as a covered benefit for our citizens. So in that regard, how do we legitimately argue that non-action is an appropriate course of action, or lack of action?”

Hoffman responded, “I’m not an expert on the abortion provisions, however I’ve been told that there is no distinction between a federal exchange and a state exchange with regard to termination of pregnancy. … That’s my understanding.”

In response to questions from other senators on the committee about whether he backs a federal exchange, Hoffman said he’s been hearing from “groups around the country” that don’t want Idaho to set up a state exchange, and that believe that “Idaho’s adoption of the state insurance exchange will be the scratch in the veneer that leads to ... this very, very bad, tyrannical public policy.”

Sen. Todd Lakey, R-Nampa, asked Hoffman, “You believe that if we don’t do anything, the federal plan will fall apart?” Hoffman responded, “It’s certainly a possibility.” When Lakey asked Hoffman if he agreed with him on what he called a “basic conservative” concept, that state is better than federal, Hoffman said, “Not necessarily,” because he said either could lead to “tyranny.”

Lakey said, "I think there are examples of where the state has done a better job than the federal government, whether it's managing wolves, or DEQ regulations."