State run insurance exchange unlikely

COEUR d'ALENE - Clock's almost up.

Idaho is running out of time to establish a state-run insurance exchange under the president's new health care overhaul, meaning that working on an alternative with the federal government is all but unavoidable.

At least that's the opinion of a consultant for the 13-member panel analyzing how Idaho should proceed.

And a Coeur d'Alene legislator on the panel agrees.

Realistically, Idaho can't sculpt its own insurance marketplace in time to meet federal deadlines, conceded Sen. John Goedde, a member of the working group Gov. Butch Otter created this summer to sort through the issue.

"Theoretically, (a state exchange) could still be done, but the chances are remote, just because of all the hoops you have to jump through," Goedde said.

The Coeur d'Alene Republican agreed with a panel consultant on Tuesday that the state wouldn't have time to create a blueprint of a customized exchange by Nov. 16, the deadline under the Patient Protection and Affordable Care Act.

State run exchanges must be operational by January 2014, Goedde added.

Many states have been planning their exchanges for over a year, Goedde said. But Idaho isn't among them, as the Legislature chose not to appropriate the $20 million available for implementing its own exchange.

"I believe the reason is they were hoping there would've been a different outcome by the U.S. Supreme Court," Goedde said of the high court's decision to uphold the federal health care reform.

Members of the Republican-dominated Legislature have been among the nation's most vocal opponents of Obama's Patient Protection and Affordable Care Act.

Robert Mitchell, a Denver-based consultant with KPMG LLC hired to help the state make a choice, spoke on the issue Tuesday before the Health Insurance Exchange working group, according to the Associated Press.

It's too complicated and risky at this point to launch a state-run exchange, Mitchell stated. Idaho could end up ceding control of an insurance exchange to the federal government, he added.

But other options remain for Idaho, Goedde said on Tuesday.

The committee has heard presentations from several other states on their own plans, he noted.

The Gem State can followArkansas in pursuing an exchange "in the partnership arena," that would be a combination of state and federal jurisdictions, Goedde said.

Idaho could also designate a nonprofit to develop a state health care exchange, which the state could transfer to down the road, he said.

Goedde does worry about switching from a federal or joint model to a state version, though.

"It could be very complicated, and it could be expensive," he said, noting that states will have an ongoing option to switch exchange models. "Just unwinding the federal exchange and rewinding everything that had to be done for the federal exchange onto a state level."

The committee, organized in July, will make a decision at its fourth and final meeting later this month, he said.

Some state officials are still hoping presidential candidate Mitt Romney is elected and follows through on promises to block the health care reforms.

"We need to do with what we can to stop implementation with that whole Obamacare thing," said Sen. Steve Vick, R-Dalton Gardens. "Frankly, I'm still working on what the next step is. I think if we elect a Republican United States president that will help significantly. If we don't, that will make it more challenging."

Rep. Vito Barbieri said the Legislature has preferred to take its time, looking at other options to a state exchange. For instance, exploring higher deductibles while employers save money for employees in a medical savings account.

If the state ends up under a federal exchange, officials can use that experience to make a more informed decision, he said.

"It's not a surprise, we were expecting it," he said of likely missing the state exchange deadline. "It was quite clear to us we needed to slow down and examine alternatives, rather than let this centralized plan take precedence."