House resumes exchange debate…

The House is back in session after its lunch break, and back into its debate on HB 248, the governor’s state health insurance exchange bill. First, House Speaker Scott Bedke issued a stern warning to those watching in the gallery “to help us maintain the decorum in the House.” He said, “That would include no outbursts, no clapping.”

Senate Minority Leader John Rusche, D-Lewiston, was the first to debate after the break. “In the Senate it was pigs and spurs, and here it’s mules and twine,” he said to laughter, referring to a story Majority Leader Mike Moyle shared with the House before its break about a runaway mule-and-horse pack train. “But there are a few things that I think we need to point out.” Rusche, a retired pediatrician and former health insurance executive, said, “The exchange is a new way to distribute products for individual and small group. It doesn’t involve large group, it doesn’t involve self-funded, it doesn’t involve Medicare or Medicaid. It’s only for small group and individual policies. … Those are the ones that are most sensitive to price differences.” So he said that’s where the lower operating cost for a state exchange, vs. a federal exchange, becomes key.

Rep. Brent Crane, R-Nampa, quizzed Rusche about whether he favored the “independent body corporate and politic” approach in the bill as opposed to a state agency under the state Department of Insurance. “One of the problems with it being a department of state government is you have employees, and you have PERSI, and you have purchasing and you have all the other rules of state government that you would have to work under for really what is a tool to manage private industry, which is private insurance policies.” Therefore, Rusche said, “I would pick the body corporate and politic rather than have it run by state employees. However, that doesn’t appear to be the choice we would have.”

Lawmakers are deciding whether to set up a state-based exchange – and the bill does that through the independent body corporate and politic  – or default to an exchange that would be run for Idaho by the federal government.