It’s fair to criticize Idaho leaders for just starting the process of establishing a health insurance exchange when so many other states, including Washington, are much further along. It’s tempting to let gambling lawmakers face the consequences of putting all their chips on “Supreme Court repeal.” Problem is, it’s uninsured Idahoans who would be harmed.
So to the extent the Obama administration can still bail out Idaho, it should.
The Affordable Care Act included provisions for setting up insurance exchanges. States could apply for money and establish their own (provided certain federal guidelines were met), or they could let the feds do it for them. The idea is to create an Expedia-type experience, where consumers can log on and comparison shop for insurance plans.
Gov. Butch Otter, no fan of health care reform, wanted the state to take the federal money and get started. His thinking: If the high court were to repeal the law, Idaho wouldn’t lose any money. But the Legislature rejected this sound reasoning and decided to wait. The deadline for applying for the grants came and went, and the Supreme Court upheld the law.
It would be best if each state could tailor the health insurance exchanges to their needs, but Idaho is one of 17 states scrambling to find the money and get started. Last week, the Exchange Working Group held its first meeting in Boise, listening to presentations on how it all works.
It’s awfully late to be taking Introduction to Exchanges when the final exam is about a year away. The law kicks in on Jan. 1, 2014, but consumers will need several months before that to shop the exchange and make purchases. Idaho still needs to decide on a basic health care plan and what it will cover. It needs a website and advisers to educate consumers. It needs a marketing plan. And it needs the feds to sign off on the exchange before it can start selling insurance.
In short, Idaho needs help if its uninsured population is to get help.
It would be smart for the feds to funnel money to late-starting states that are making a genuine effort to establish exchanges. Much of the success of health reform will rest on how smoothly the purchasing process goes. Shoppers are as apt to blame the Obama administration as Idaho lawmakers if the experience is a nightmare.
If the clock runs out on Idaho, then the feds might have to establish the initial exchange. However, control could be gradually shifted back to the state if the feds would agree to a partnership.
Yes, there might be short-term pleasure in sticking it to defiant state lawmakers, but federal officials need to keep their eyes on the larger prize, which is providing health care coverage to the previously uninsured. By the same token, Idaho legislators need to drop their anti-reform pose.
Time is short and cooperation is imperative. Partisan politics will cure nothing.