Speaking before a panel tasked with finding a solution toward improved health care, Idaho Freedom Foundation executive director Wayne Hoffman likened Idaho’s relationship with the federal government “as an abuser to a spouse” on Friday.
“We keep getting beat up by the federal government and we keep running back to the federal government,” he said.
Hoffman was one of a 13-member panel examining the role of the Affordable Care Act in Idaho.
Ultimately, at its conclusion late Friday afternoon, the Idaho panel voted to recommend to Gov. C.L. “Butch” Otter that an Idaho-based health insurance exchange be crafted.
Under the ACA, states are required to set up an exchange, an online marketplace for insurance policies, or have the federal government set one up for them. Friday’s panel and another working group were assembled earlier this year to decide on a course of action.
Throughout Friday's daylong session, the panel heard comments from groups, including Maximus, Mercer Health, Cognosante and the Leavitt Partners, about implementing a state-based exchange, and about the progress other states have made.
An hour of late-afternoon debate included Alex LaBeau, Idaho Association of Commerce and Industry president and panel-member, expressing concerns about the ACA, but saying the state-based exchange was "the better route."
“My recommendation, my motion, is that our recommendation to the governor is to pursue a state-based exchange through the nonprofit model, because it’s probably the most flexible model,” said LaBeau.
LaBeau said he felt that the Idaho model would give the state power to absorb increased costs. But he enumerated two caveats: one, that the makeup of the directors of the nonprofit include as many shareholders as possible, including insurance companies, brokers, small businesses and providers; and two, that he was uncomfortable with the federal government’s impact on the state.
Yet Hoffman argued that Idaho should refuse to implement the ACA and reject establishing an exchange.
“I think it’s in the best interest of the state to keep resisting this constitutionally dubious law,” said Hoffman.
Boise Republican Rep. Lynn Luker suggested Idaho should make a recommendation to do nothing, and let the federal government implement an exchange. He moved to recommend the governor address the exchange in one year.
Lewiston Democratic Rep. John Rusche, a physician, spoke in support of LaBeau’s motion, and suggested costs would be higher for payers with a federal exchange.
“If we were to say, ‘hell no, let’s just have the feds do it,’ it would amount to charging the state of Idaho $120 million more for the same insurance coverage they have now by our choice, or by the governor’s choice,” Rusche said.
However, before the panel took a vote, Hoffman suggested Idaho had a chance to show state sovereignty was important.
“The cost of going along with government tyranny is more than any of us here can imagine,” said Hoffman. “And I think that should weigh on our conscience as we decide here today.”
Ultimately, the panel's suggestion to move forward with a state-based exchange now heads to the governor's desk.