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BOISE -- Throughout the insurance exchange debate, Idaho lawmakers have quietly kept an eye on our neighbors to the south.
Before the Affordable Care Act passed, Utah already had its own state exchange for small businesses, and was going to expand that to include individual plans. This week, Utah Gov. Gary Herbert changed course and asked for a federal-state partnership to run its exchange, with the state taking care of the small business exchange and the federal government running the individual exchange. The federal government is reviewing the request.
Idaho'sSenate Commerce and Human Resources Committee voted 8-1 on Thursday, Feb. 7, to pass the exchange bill to the Senate floor. Discussion before that vote showed some exchange opponents see Utah's move as a sign the federal government is inflexible. Some supporters, however, see it as a sign the feds are willing to work with states.
During testimony on Gov. C.L. "Butch" Otter's state-based insurance exchange bill on Thursday, former Idaho Senate Majority Leader Rod Beck pointed to Utah as an example of states having no flexibility with exchanges.
"The governor of Utah just yesterday tried to find a seat at the table and he found out there wasn't even a table," Beck said. "(Department of Health and Human Services Secretary) Kathleen Sebelius essentially kicked him out of her office."
That's not quite what happened, according to the Department of Health and Human Services. HHS press secretary Fabien Levy provided this quote from an HHS official: "The Secretary had a productive discussion with Governor Herbert on Tuesday. She asked a number of questions about how the state envisions its proposal would work, and the Governor agreed to provide further information for the Department to review. The Secretary told Governor Herbert that HHS wants to continue to be as flexible as possible and HHS will continue working closely with state officials moving forward."
David Hensley, chief of staff for Otter, said Otter and Herbert spoke on the phone on Wednesday, and that Herbert has another meeting with Sebelius soon.
"As they move forward, we're interested in hearing how that develops," Hensley said during testimony.
After the meeting, Hensley said the concern about HHS not working with Idaho is nothing new.
"Over the course of hearings, people were concerned about a lack of flexibility on the federal government's front," Hensley said. But the governor's office is interpreting the negotiations between HHS and the federal government as a sign that the bargaining table does, in fact, exist.
Sen. Jim Patrick, R-Twin Falls, said Utah's actions could change lawmakers' minds if they see it as inflexibility on the government's part.
"If the (federal) government doesn't agree with what they do, (Idaho) might not be able to go far enough to satisfy them," Patrick said.
Rep. Clark Kauffman, R-Filer, said he hadn't yet decided how he felt on the exchange, but Utah's request didn't affect his thought process. Because Utah already had an exchange pre-Affordable Care Act and Idaho is starting from scratch, the two states' situations are "apples and oranges," he said.
"Our decision is different," Kauffman said.
But, Patrick added, regardless of what happens with Utah, he still wants to explore a state-based exchange. On Thursday, he voted to pass the bill to the floor.
"I'm too conservative to allow the federal government to run the exchange," he said.
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