Out of the collapse in Congress of efforts to replace Obamacare comes a golden chance for Idaho to find its own approach to caring for thousands of Idahoans who don’t have and can’t afford health insurance. Gov. Otter and his new health working group should make that happen immediately. We’ve squandered enough time.
Under existing Obamacare rules, as well as in all the major Republican health proposals, were provisions for states to ask for waivers to craft their own individual health plans. Among the 32 states that have expanded care are states like Indiana, led by then-Gov. Mike Pence, that seized the opportunity to fashion a solution that worked for them.
Idaho knows how to do this. In 2013, the Legislature authorized Idaho’s own health insurance exchange, a decision that has proved smart and efficient. Idaho can act in a similar way to help the people who remain without insurance, trapped in what we now call “the gap.”
As many as 78,000 working families fall into the limbo of making too much to qualify for free health care and not enough for subsidies to buy their own insurance.
Up until now, Gov. Otter has waited for the Legislature to act. He told the Statesman this year that he had committed long ago to legislative leaders that he would not act unilaterally.
OK, but much has changed since he made that pledge. That promise came when the governor and the Republican-controlled Legislature didn’t trust the Democrat who occupied the White House.
There’s no reason that Otter can’t ask legislative leaders today for their blessing to work with the Trump administration. The governor can say: “Look, Obama is gone. Let me and my team work with our Republican allies in D.C. on an Idaho plan that I will present to you, Republican legislators.”
The job may be easier now. Seema Verma, the architect of Pence’s Indiana plan, is now the person reviewing plan waivers for the whole country. Plus, having an Idaho plan in place will be important if a new GOP health bill does emerge that protects states that have expanded their coverage.
If Idaho writes its own plan, Idaho can make sure to address Idaho concerns and build in Idaho-specific safeguards. Previous working groups already have outlined the values that plan would weave in: Require personal responsibility on the part of recipients, so that it does not become a permanent “entitlement.” The Idaho plan would have programs and incentives to encourage positive health behaviors. The Idaho plan would emphasize primary and preventive care. It would fix Idaho’s inefficient system for paying uninsured and indigent care. And it would aim to control the rising costs of insurance and care for all Idahoans, not just those who get government assistance or subsidies.
The right plan will leverage money from the federal government to do what we want: Treat the poor and sick humanely and efficiently. Provide early and preventive treatment that is timely and cost-effective. Create a system that is careful and frugal with our tax dollars.
So let’s do it. If the way to get it done is through the new Governor’s Health Care Advisory Panel, chaired by retired Health and Welfare Director Dick Armstrong, great. Armstrong is credible and widely respected. He knows what Idaho needs.
Idaho knows what it wants in a plan. Otter has a partner in the White House eager to put states in charge of their own destinies. There’s no reason not to act. If Idaho is having this same conversation next year, we will have fumbled tragically.
Unsigned editorials represent the opinion of the Statesman editorial board.