Gov. Butch Otter says he’s very interested in what states like Arkansas, Indiana and Iowa are exploring, in taking the federal Medicaid expansion funds and instead using them to purchase private health insurance for the new recipients. But he said he wants changes in Idaho’s system to promote more personal responsibility before Idaho expands coverage. “It doesn’t do any good if you’re just paying for every time a patient crosses that threshold, and that’s your primary billable occasion,” he said. “I want to see better health care outcomes. So I think combine those two ideas.”

Asked if Idaho can take that step this year – when the federal money is available to fund the move – the governor said, “I would like to say that that’s in the State of the State, and it is.” He gives his State of the State message to a joint session of the Legislature on Monday, and is being careful not to tip his hand about all his proposals.