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To Idaho’s Health! 

Gov. Butch Otter has made the right call on an Idaho-run health insurance exchange; the Legislature needs to follow his lead

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Let’s toast Idaho Governor Butch Otter’s good decision to choose a state-based health insurance exchange for our generally risk-averse state. Now we can hope, pray and lobby our legislators to agree with his choice when they convene in Boise in January.

Legislators may be wary because of their intense dislike for President Obama’s Affordable Care Act, or because it’s simply hard to read the tea leaves on how an insurance exchange is actually going to work.

What are we talking about exactly? A health insurance exchange is supposed to be a one-stop shop for individuals and small business owners to browse online and purchase health insurance from a variety of plans, comparing prices, benefits and services. Medicaid is included in the choices for those who qualify.

As you may have already read many times, each state has been given the option of setting up their own exchange, or a hybrid partnership with the government, or just turning it over to let the federal Health and Human Services agents devise a plan for the state.

The exchange concept went nowhere during Idaho’s last legislative session. But the U.S. Supreme Court’s validation of Obamacare and Obama’s re-election has drastically altered the game.

To some, the novelty of setting up a state-run, virtual store for folks to buy their health insurance may seem like buying a pig-in-the proverbial poke. At last count, 30 states are opting to let the feds do it for them.

But Idahoans are usually sure we can do things better locally than at the federal level. We cherish our rugged individualism. Idahoans support states rights and all that.

It’s not the first time our conservative state has taken a bold step. In 1939, a lot of teetotalling Idahoans were probably offended when Idaho went into the business of selling hard liquor. But the state liquor business has been a pretty good moneymaker for Idaho taxpayers ever since. Now, most non-drinking Idaho legislators would quietly argue against privatizing the sale of hard liquor. Sale of booze through the state liquor stores is projected to bring in $18 million to the state’s coffers in this fiscal year.

It is difficult to bring clarity to the fuzzy picture of a state health insurance online market, partly because there are so few definite details. The details that can be identified are confusing, and are written in barely intelligible governmentspeak, which frankly makes for dull reading.

But the subject is very important.

After trudging through the Idaho Health Insurance Exchange Working Group Findings of October 30, 2012, I could only conclude that Otter’s working group weighed the pros and cons carefully and thoroughly before making its recommendation to the governor.

In its findings, the group lists 25 areas where the state can retain its power to chart the state’s path to providing optimum value for Idaho’s families and businesses and lower their insurance costs. Among those choices the state will retain are the structure and operation of the insurance store, how the store will be financed and how it will be run.

I won’t list the 21 other areas the state keeps control of for the reason listed above — they aren’t by themselves very interesting. But you can find them, online, in the impressive Report of the 2012 Idaho Working Group Findings.

In uncharted territory, the working group’s conclusion that Idahoans will benefit by keeping controls close to home makes very sound sense.

Idaho doctors agree that a state-based insurance exchange can better meet the unique medical needs of Idaho, with its relatively small population and extensive rural spread. Dr. Robert McFarland of Coeur d’Alene, president of the Idaho Medical Association, told me Idaho physicians are able to contact and influence the local insurance companies when their policies cause problems for patients.

Dr. McFarland noted that, even though a federally managed exchange would possibly attract more competition to Idaho’s Blue Cross and Regence Blue Shield monopolies, national companies tend to underserve as well as underbid the nonprofit “Blues.”

It will be up to the newly installed Idaho Legislature to keep the program on track. Dan Popkey of the Idaho Statesman reports that the skids may be being greased for approval of the state-based insurance exchange option. Let’s hope so.

I suggest that folks living in Idaho lean on their freshly elected legislators, urging them to support this move to bring affordable health care to all Idahoans.

The dream is that by 2014, individuals and small business bosses will be able to sit at their computers and shop for affordable health insurance plans that best fit their budgets. Computers will be available for those who do not own one. And everyone, if the Medicaid expansion goes through, will be covered by some kind of health care plan.

Happy New Year! 

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