Gov. Butch Otters office will introduce legislation today to set up a state-based health insurance exchange through the Affordable Care Act at Tuesdays Senate Commerce and Human Resources Committee meeting.
1. Will it adhere to federal guidelines? A piece of legislation drafted last year a bill never introduced set up the bare bones for the online marketplace. Bill author Rep. Fred Wood, R-Burley, admitted the bill didnt meet all of the federal rules, but hoped a basic exchange would satisfy both the Idaho Legislature and the U.S. Department of Health and Human Services. The governors bill might take the same approach, or may follow the federal guidelines more closely.
2. Who will be able to buy insurance through the exchange? Some state exchanges allow businesses with 50 employees or more to shop the exchange, while others say 100 employees or more. So far, theres no indication what the governor will propose.
3. What are the parameters for insurance companies to participate? By setting up its own exchange, Idaho has more control over the requirements for insurance plans offered through the marketplace.
4. Who will govern the exchange? States can decide who governs the exchanges board and who makes those appointments. Some states split appointments between the governor and legislature or attorney general. Others, like Hawaii, leave all appointments to the governor.
Also to be determined: The number of people who serve on the board. States that have their own exchanges have boards ranging from five to 15 members.
5. How will the Senate committee and the rest of the Legislature react?
Tuesdays meeting is a print hearing, meaning sponsors are merely introducing the bill and the committee wont take public testimony. But if the bill passes the print hearing, the Commerce and Human Resources Committee will hold a full hearing, complete with public input, before voting. If it clears the committee, the bill has to pass both the House and Senate. Either body can add amendments to the bill. Individual lawmakers have already expressed concern with the idea of the state voluntarily participating in the ACA, so the state-based exchange isnt a guarantee.