Remember the howl that went up from the Idaho Legislature last winter during debate on whether the state should actively oppose a health care reform law approved by Congress?
Its answer to the Patient Protection and Affordable Care Act wasn't just "No," but "Hell, no!"
Well, "Hell, no!" is freezing over.
Faced with a choice between setting up a state-controlled health-insurance exchange with a $40 million federal grant or letting the federal government create its own, Idaho Gov. Butch Otter urged a state health-care task force this week to take the money and keep control. The state also has the option to set up and pay for its own exchange, which would pinch the cash-short state more than it's pinched already.
A federally run exchange could force 2,500 private insurance agents out of business, state officials say.
A state legislative panel is now drafting a law to allow the state to accept the grant to set up the exchange.
In a fiery session last winter, the Legislature voted to opt out of complying with portions of the Affordable Care Act and debated "nullifying" the whole thing, which would have been unconstitutional.
Gov. Otter vetoed the legislature's plan and issued an executive order banning the state from accepting any federal money to get the program going unless it got a waiver—from him.
And waive, he has. Since July, he has approved 10 of 13 state agencies' requests for federal money under the law. Idaho has gotten money for a stop-smoking campaign, homes to care for Medicaid recipients with chronic illnesses that require expensive treatments, a grant to increase the state's ability to identify and respond to disease clusters, and money to boost best practices for common chronic diseases. Idaho State University got $1.2 million to help train family doctors and physicians' assistants.
Idaho ultimately joined a lawsuit along with a dozen other states to try to overturn the law. The case is working its way through the legal system.
In the meantime, Idaho residents with and without insurance will have a chance to easily compare the costs and benefits of various private insurance plans and to seek insurance through the new health insurance exchange.
The transparency provided by the exchange is anticipated to increase competition, help keep prices in check and influence industry practices that sometimes include denial of coverage to individuals with pre-existing illnesses.
With the hell of federal intervention now frozen over, businesses and individuals may have a chance to succeed in containing health insurance costs instead of being consumed by them.
