Idaho Gov. Butch Otter told the Legislature's Health Care Task Force this morning that Idaho has been working on the idea of a health insurance exchange since 2007, and "That idea I believe was co-opted by Obamacare." In fact, he said, "We find that many of the things we were doing in Medicare, many of the things we were doing in health care services for children adults, from Medicaid services to dentistry, have been co-opted by the Affordable Health Care Act." That's why, he said, he's issued waivers for 10 of the 13 requests he's received from the state Department of Insurance and the state Department of Health & Welfare under his executive order that forbids accepting any federal health-care reform money without his personal approval for a waiver.

Otter said Idaho is "at a crossroads," at which it must decide - by Sept. 30 - whether or not to apply for a $40 million federal grant to build a new Idaho state insurance exchange. "If we do not apply for the grant, then under the Affordable Health Care Act, the federal government will come in and establish and impose upon us ... an insurance exchange." It would make use of national insurance firms, he said - not Idaho companies.  "The date of Sept. 30 is coming at us at a rapid rate," Otter told House and Senate members who serve on the joint task force. "What's the state going to look like in terms of our health care exchange? ... Should we decide not to go for the $40 million grant, and let the federal government then assume responsibility for the health care exchange within the state of Idaho?"

House Health & Welfare Chairwoman Janice McGeachin, R-Idaho Falls, asked if Idaho couldn't set up its own exchange without taking the federal money. Otter said that's possible, but there'd be a cost. He also noted that Idaho could apply for and receive the grant, and then - as Kansas and Oklahoma already have done - decide to return part of it rather than comply with regulations attached to the money, without having to pay back any portion already spent. "We can stop - return the money and we're not required to return any of the money that we've already spent," Otter said.