Idaho panel votes for state-run health exchange

BOISE - Gov. Butch Otter’s health insurance exchange working group has voted overwhelmingly in favor of a state-based health insurance exchange, opting for the model of using a private non-profit group set up by the state to run it. The recommendation now goes to Otter, who must notify the federal government of which way the state will go by Nov. 16. If the state does nothing, it gets a federally run health insurance exchange and loses state regulatory control over its health insurance industry. Only two member of the 13-member panel dissented in the decision, Rep. Lynn Luker, R-Boise, and political activist Wayne Hoffman. Hoffman compared the state’s relationship with the federal government to “the relationship of an abuser to a spouse. We keep getting beat up by the federal government and we keep running back to the federal government, and we have done it time and time again.” He said, “I think the best interest of the state is to continue to resist this constitutionally dubious federal law. … The only way you’re going to get the federal government, Congress and the executive branch to reconsider the law is just to resist its implementation.” Kevin Settles, owner of Bardenay restaurants, countered, “We need to get past arguing the legality of the law. The Supreme Court settled the issue.” He said, “We can make something good out of this. … With the state-based non-profit exchange, we can make it reflect Idaho.” He noted that Idaho’s current insurance premiums are among the lowest in the nation. Luker offered a substitute motion to hold off on any decision for a year, but it won votes only from him and Hoffman. Alex LaBeau, head of the Idaho Association of Commerce and Industry, made the successful motion for a state-based non-profit health insurance exchange. “We’re all paying for everybody’s health care as it is, whether it’s through Medicare and Medicaid, your property taxes or your insurance,” LaBeau said. “The other important thing to remember, in a small state like Idaho, this is going to impact small employers.” He said small employers - those with 50 or fewer employees - are 96 percent of Idaho’s employers, and they employ half of Idaho’s workers. “That’s a substantial number of Idahoans that are going to be impacted by the decision that is made here today.” LaBeau called for the state-based, private non-profit model, “because it’s the most flexible.” He said a state-based exchange is the only way Idaho can protect small employers from big jumps in their costs and maintain Idaho’s regulatory role over its insurance industry. Rep. John Rusche, D-Lewiston, said opting for a federal exchange would mean much higher health insurance costs for Idahoans, “charging the citizens of the state of Idaho $120 million more for basically the same insurance they’re getting now.” Panel member Tom Shores said, “I think the problem is we’ve waited long enough. We couldn’t get the Legislature to do anything.” Waiting again, he said, would be “folly.” Idaho lawmakers took no action on a health insurance exchange in their 2012 session, betting instead that the national health care reform law would be overturned by the U.S. Supreme Court. Instead, it was upheld. Panel member John Watts said, “I just don’t know why we’d want the federal government to control absolutely everything if we have an option to avoid that.”