The bill that then-House Speaker Nancy Pelosi, D-Calif., so famously said would have to pass in the U.S. House back in 2010 "in order for us to know what's in it" has now been shipped for implementation to Idaho in the form of a virtual crate of largely unlabeled spare parts that the Idaho Health Insurance Exchange Board (IHIEB) is dutifully attempting to assemble in the next 40 days.
We feel their pain and respect the daunting task before them, because this is the stuff of federal bureaucracy coming to a health provider theater near you.
Commonly known as "Obamacare," the Patient Protection and Affordable Care Act is now law - law that even some of the most outspoken Idaho critics of federal health care reforms no longer quibble with since the U.S. Supreme Court basically codified it last year. To add to the drama and the duties, several IHIEB members told the Spokane Spokesman-Review that they have received phone calls threatening them with lawsuits over their participation.
But Idaho has made its choice - a choice we supported given the alternatives - to create a state exchange; now all that is left is to create a structure and tend to the implementation.
Susan Johnson, region 10 director of the U.S. Department of Health and Human Services (covering Alaska, Idaho, Oregon and Washington) was in town Monday from Seattle to help guide the 19-member exchange board, which is populated by doctors, insurance executives, health care providers, business leaders and legislators, to name a few. She seems a very bright and capable person, but it is still an odd and unsettling feeling to watch bureaucracy at work before our eyes.
Johnson gave the board a series of deadlines from May 10 to the end of May, at which time they have to make decisions about how they are going to organize. Given that some of Idaho's estimated 100,000-plus new health care customers could be coming online or inquiring by October, the time is short. "You'll have to clone yourselves to do all the work," she said, half-jokingly, about the challenge.
The panel immediately got to work and created six committees to pore over options, arrange for legal counsel and consider a place where all of these new faces might office - most likely off-site of the Capitol. The board can certainly review the work of Oregon and Washington - two states further along in the process.
Today, the board was to be in executive session to interview a potential executive director for the exchange - a person who could assume much of the heavy lifting for board members, many of whom are volunteers with day jobs or are retired.
There is no looking back, so we wish the board the best in making the exchange with a "light footprint," as some have described it. We hope this is possible given that the Affordable Care Act, in its physical, printed form was more than 2,000 pages and weighed in at nearly 20 pounds when it hit the printer's office in 2010.
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