BOISE Incensed over Obamacare, Idaho lawmakers last session snubbed $20 million from the federal government earmarked for an insurance exchange and refused even to make baby steps toward establishing this online marketplace for individuals and small companies to shop for coverage.
Despite the threat of the federal government imposing its own exchange on Idaho, House Republicans instead banked on the U.S. Supreme Court dumping President Barack Obamas health care overhaul.
Since justices went the other way Thursday in a 5-4 decision, Idaho insurance companies are now calling for renewed action that will allow them to offer their products in a market they currently dominate.
Still, lawmakers say it would take lightning-quick action by Idaho, combined with a lenient federal government, to meet a Nov. 16 deadline to submit a plan for exchanges to the U.S. Department of Health and Human Services.
I dont know if theres time to do anything, said Rep. Fred Wood, R-Burley, a doctor who unsuccessfully pushed for a state exchange during the 2012 session. I worry, and I suspect, were going to wind up with a federal exchange.
Thats a scenario Blue Cross, Regence Blue Shield and PacificSource, the states biggest insurers, are hoping to avoid. They say it would boost costs for consumers, provide insurance products ill-suited to rural Idaho, and leave consumers at the mercy of an out-of-state system.
Hours after Thursdays high court ruling, Blue Cross, which insures about 500,000 Idahoans, urged Idaho lawmakers to arms.
In Idaho, our major focus should now be on establishing a state-based ... exchange, the company said in a statement. A state-based exchange ensures Idahoans are clearly represented when deciding how they will purchase individual insurance in the future.
The state Department of Insurance declined comment Friday, but indicated that the $20 million federal grant is no longer on the table, even if Idaho wanted it.
That narrows options for Gov. Butch Otter, who returned to the office Friday from an annual trail ride to be debriefed on the issue and decide a course of action.
Were having meetings on that. ... All of those options in the aftermath of this decision are on the table and are being discussed, said Otters spokesman, Jon Hanian.
One thing Otter isnt planning on is a special session to ask lawmakers input, Hanian said.
A likely reason? Republican lawmakers appear to be no more favorable toward a state exchange now than they were during the 2012 Legislature. Some are simply banking on Mitt Romney winning the presidency in November to help stall Obamas reforms.
Given the Idaho GOPs unabated enmity for the health overhaul, an extraordinary legislative session could be a recipe for political chaos.
House Minority Leader John Rusche, D-Lewiston, is a former Regence Blue Shield executive who favors a state exchange.
But as a Democrat, he knows that the Supreme Courts ruling has done little to change the majority GOPs mind.
Who is going to agree to a special session to implement Obamacare? Rusche said. How many Republicans are going to be willing to do that?
One skeptic is Rep. Janice McGeachin, outgoing chairwoman of the House Health and Welfare Committee. Shes wary that Idaho insurers are demanding a state exchange to protect their business models, not consumers.
McGeachin, R-Idaho Falls, contends that a proposed state-run exchange, like one that emerged from interim legislative meetings in late 2011, gives too much power to Idaho insurance companies and does too little to promote price-dampening competition.
If a federal exchange would allow for more of that consumer choice, what would be wrong with that? she said.
Its not a question of who gets to compete, said Karen Early, a Blue Cross spokeswoman. She said the real question is who will be in charge of crafting the marketplace for individual insurance to be sold.
Early contends that a state-run exchange will offer plans that cost half the premiums of those available on a federal exchange.