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The case for Idaho health exchange

by Kevin Settles
| November 30, 2012 8:00 PM

An important deadline is looming for Idahoans when it comes to determining what they want and what is available to them for health insurance. A key provision of the new health care law is the formation of health insurance exchanges; online marketplaces where people can research and purchase health insurance. The exchanges are intended to provide a benefit to the citizens of Idaho by simplifying the complexities of the available plans as well as review the applicant's eligibility for Medicaid, Medicare or tax subsidies.

The Supreme Court has ruled an exchange is coming. We can take a proactive approach and set up our own exchange, or a defensive one, and let the federal government build and run it. In my role as a part of Gov. C.L. "Butch" Otter's work group in the health exchange question, I voted for an Idaho exchange. We have historically had some of the lowest health insurance rates in the nation. We are an active state with generally healthy residents and are discriminating in our use of medical services.

These are not the only factors that have helped to keep our rates low. Our state government and the Department of Insurance have never required that a lot of extra features, called mandates, be added to our policies. Our state has four mandates while some states have over 100! That means that our basic policies are all business and no fluff. You can add the fluff if you want but it is your choice.

The citizens of Idaho have always been strong supporters of Idaho-based businesses and you can see that support reflected in the sales of my restaurants. People talk about and want to purchase Idaho-grown items off my menu. The exchange will feature a menu too. If we do nothing, it will be a DC menu, written and managed largely by people who live and work back there.

Why are some people in this state willing to have an insurance menu that features only DC policies? Since there is federal funding for establishment of the exchanges, no matter who does it, and the users of the system are required to pay for its ongoing operations, no matter who runs it, I see no gain in a federal exchange.

Through my participation in the Governor's Healthcare Exchange Task Force, I have learned that we do have options for the formation of our exchange but we need to start now. The state could set up the exchange but it would be difficult for them to meet the timeline. Another option that may be better suited to Idaho would be a non-profit corporation designated by the state to run the exchange. This non-profit corporation would still have to meet the requirements of PPACA and would be subject to oversight by the Idaho Department of Insurance. That would ensure that there is sufficient oversight to make sure that the organization works for Idahoans. This entity would be eligible for federal funding to pay for its development yet would have the freedom that private business have. Best of all, it would be run by people that live and work here.

Our work group spent three months studying this issue, and voted 10-2 in favor of the state-based exchange. I'm hoping Governor Otter will accept our recommendation and choose by Dec. 14 to create a state exchange and that you will support him when he does.

Kevin Settles is president and CEO of Bardenay Restaurants.