Idaho will run its exchange, sooner or later
February 9, 2013
Idahoans will have a health insurance exchange - and their state will manage it. Maybe not now. But soon.
Don't think so? Remember 1995, when everybody was apoplectic about federal reintroduction of wolves? You didn't have to like wolves to agree with reasonable people like Resources and Conservation Chairman Golden Linford, R-Rexburg. He insisted Idaho was better off if the Fish and Game Department at least managed wolves.
That's hardly a new idea. Idaho's Department of Environmental Quality enforces federal programs, the Department of Health and Welfare has discretion over Medicaid and the Idaho Transportation Department exercises latitude over federally funded highway projects.
This time, however, Linford might as well have tried spitting into the wind. Legislators acted as if voting against state management would vaporize the wolves. Into the sand their collective heads went.
Wolves stayed put - under the care of the U.S. Fish and Wildlife Service and the Nez Perce Tribe.
Not much later, the complaints emerged:
Why, cattle ranchers wanted to know, did feds take so long to respond to wolf attacks on their herds?
Why, sheep ranchers asked in frustration, would the feds cautiously eliminate one wolf rather than an entire pack?
Why, hunters argued, were the state's game herds left in jeopardy?
And why were Idaho's priorities not more reflected in the policy and research decisions made by federal and tribal officials?
Seven years later, Gov. Dirk Kempthorne and state lawmakers eagerly sought - and got - a larger state role in supervising wolves. And that insurgency of 1995? It never happened.
Now the same crowd who brought you repeal of the 17th Amendment, nullification and abolition of the Federal Reserve is hawking a new fantasy: Reject Gov. C.L. (Butch) Otter's practical argument that Idahoans running an Idaho exchange can do a better job for Idahoans and Obamacare will disappear.
"If Idaho's Republican lawmakers decide to embrace Obamacare, Idaho will be making it difficult for other states to continue their resistance," says state GOP Chairman Barry Peterson.
Says former House Health and Welfare Committee Chairwoman Janice McGeachin, R-Idaho Falls, there isn't "much distinction between" a federal or state exchange.
And Idaho Freedom Foundation Executive Director Wayne Hoffman calls it a "form of phony federalism that will hurt your constituents in the long run."
They could not be more off base. Obamacare survived the U.S. Supreme Court and the presidential election. Left to Idaho is this choice: Operate an exchange from which small businesses and individuals can obtain insurance - or defer to the feds. If that happens, the protests won't be far behind:
If the state is in charge, administrative fees would have cost someone $4 to $7 a month. Leave it to the feds and the costs rise to $12 to $15 a month.
Idaho's small businesses and individuals who buy policies under the exchange will pay the national average rather than Idaho rates. For individuals, that's $50 a month more. For groups, that's $1,800 a year per employee higher.
People will lose jobs. Idaho's health insurance carriers - including Lewiston's Regence BlueShield - will find themselves frozen out of the health insurance exchange.
Health care providers who once resolved claims by calling a local representative - or even meeting face to face - will struggle with agents based in regional or national offices.
In the face of such anguish, the loud mouths will slink away. The grownups will have to clean up their mess. And Idahoans will have the same deal they could have so much earlier and easier.
It's only a matter of time.
Originally posted at http://lmtribune.com/opinion/article_a0d732b1-c6f5-5a2a-974c-31371061f220.html
The editorial posted here is provided by permission of its original publisher and does not necessarily reflect the views of Idaho Public Television.
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