The Savvy Sixteen

Despite a push to kill any state-run insurance exchange, a group of new Idaho legislators got behind the idea anyway

Refreshing news from Boise, where sixteen Republican freshman legislators burst right through the barrier of tradition. Led by Representative Luke Malek, a newly minted legislator from Coeur d’Alene, these savvy 16 put to rest the old adage that freshman legislators, like children, are better seen, not heard.

Instead of hanging back as freshmen are usually advised to do, these quick learners assessed the situation, recognized their strength in numbers and plunged into the legislative action. They stood up together for a press conference to explain their substitute bill to create a state health insurance exchange. In doing so they made legislative history.

I checked with legislative staff, and no one with a long history at the statehouse can remember anything comparable attempted by first-year legislators. Their actions inspired shock and awe.

After all, the Idaho Capitol Building is a proper, stately palace. Marble, both real and faux, lines the walls, the stairs, the pillars, everywhere the eye can wander. The building is beautiful, imposing and intimidating. History looks down at you from the walls. Here Idaho’s politicians through the ages have whispered, argued, shouted, made deals, engaged in fisticuffs. It’s enough to make a new legislator weak in the knees.

So where did these Republican freshmen get the starch, the guts and gumption to stand up together on the health insurance exchange bill?

Let’s re-create the scene. The Affordable Care Act, better known as Obamacare, now the law of the land, requires a state to set up a health insurance exchange or let the federal government do it for them.

Governor Butch Otter opposed Obamacare vociferously in print, on TV and in the courts. After the U.S. Supreme Court ruled Obamacare to be constitutional, Governor Otter appointed a working group to study the pros and cons of Idaho’s options. The working group recommended that Idaho choose to run its own state exchange. Governor Otter gave in to that recommendation, but tossed the ball back to members of the Idaho Legislature to make the final decision. Many thought it would go there to die — and send a message about health care to the rest of the nation.

So in January of this year, the governor’s bill, Senate Bill 1042, was introduced. It would create a state health insurance market where Idahoans could browse and shop online for insurance to cover their families’ needs.

The governor’s bill presented the 16 Republican freshmen something of a challenge. As committed conservatives, aren’t they supposed to just spit out any pill related to Obamacare? But they are not ideologues. Even though they are surrounded by lobbyists, pro and con, at every turn, they want to make up their own minds.

Among the lobbying forces was the unlikely, even unwelcome, Congressman Raul Labrador, who is wildly opposed to establishing a state health insurance exchange. He wants to seriously undermine Obamacare however he can. He may also be running for governor, and is not above undermining Otter.

My guess is the GOP freshmen were made uncomfortable by Labrador and others who wanted to persuade them. They were angered by veiled or unveiled threats that they might have primary opponents in the next election if they didn’t vote against the governor’s health insurance exchange bill. That’s a painful thought for any freshman who has just barely recovered from the physical and emotional ordeal of a tough campaign. And nobody likes being bullied.

So the Republican freshmen, with their wits about them, chose to come together and offer what they considered to be improvements to the legislation, changes that would include legislative oversight and open meetings the public can watch or attend. The substitute bill adds two legislators to the proposed Exchange Board, requires meetings of the Exchange Board to be open and well-publicized, and provides an exit clause for the state to bail if given cause.

From my vantage point 400 miles north of the action, I assume the Republican freshmen’s goal has been to make Governor Otter’s bill more acceptable to them and their fellow Republican legislators. The freshmen also wanted to establish their allegiance to states’ rights and state sovereignty, to prove they hadn’t gone bonkers and over to the other side.

I was convinced of the wisdom of managing the health insurance exchange here in Idaho by my family doctor, who pointed out that lower costs and better coverage are the two strongest arguments for keeping the exchanges under state control. (The initial costs will be funded by federal grants to the state, while continuing costs will be covered by user fees; the federal exchange option would include a 3.5 percent premium surcharge.)

As I write this, the Senate has passed the governor’s bill by a comfortable 23 to 12 vote. The House freshmen’s substitute bill is still in the works, and the two measures will need to be reconciled. The prospects for our own insurance exchange look good, thanks to a welcome burst of political courage. 

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