Opinion: Idaho now has an insurance committee. Can it make a difference?

For much of my professional life, I have worked in insurance and financial services. I understand why insurance exists, the important role it plays and the challenge insurers face in controlling costs while keeping coverage affordable. I also understand why people are frustrated.

Few things are more frightening than a serious health problem. When someone is diagnosed with cancer, needs surgery, has a sick child or faces another medical crisis, the last thing they need is a fight over whether an insurance company will approve treatment, pay a claim or cover a medication. Unfortunately, too many Americans have had that experience.

Gallup found that positive ratings of U.S. healthcare quality fell from 54% in 2020 to 44% in 2024. By 2025, only 24% rated healthcare coverage as excellent or good, and just 16% were satisfied with the overall cost of healthcare. Seventy percent now say the healthcare system has major problems or is in crisis.

KFF found that 6 in 10 insured adults experienced at least one problem with their health insurance during the previous year. Eighteen percent reported a denied claim, while others struggled with prior authorization, prescription coverage or high out-of-pocket costs.

Families are paying more in premiums, deductibles and copays while increasingly questioning whether their coverage will work when they need it. We cannot continue down a path where families are expected to spend as much or more on health insurance and medical costs as they do on their mortgage.

We have to get costs under control, but we also have to rebuild trust. I believe in private markets and would much rather preserve a system based on competition and consumer choice than turn healthcare over to the federal government. But if private insurance becomes increasingly expensive, frustrating and difficult to use, we should not be surprised when proposals such as Medicare for All begin to gain broader public support.

People may not embrace government-run healthcare because they suddenly want bigger government. They may simply become exhausted with the system they have. That is one reason I am grateful the Idaho Legislature is taking insurance issues seriously. A committee has been formed to study these concerns, and legislators are hearing from insurers, providers, regulators and patients.

There are several areas where I believe Idaho can make meaningful improvements. Last session, I worked on legislation addressing the prompt payment of insurance claims, and I plan to bring that effort back this session. When a provider performs a covered service and submits a clean, legitimate claim, there should be reasonable expectations for how quickly that claim is paid. The longer payment takes, the more administrative and financing costs providers absorb, and those costs eventually become part of what all of us pay for healthcare. Insurers absolutely should be able to investigate fraud, errors and questionable claims. But legitimate claims should not sit unpaid for unreasonable periods of time as regularly happens.

I have also worked with other legislators on prior authorization reform. Prior authorization can serve a legitimate purpose by helping control unnecessary or duplicative care. But it should not become an unnecessary barrier between patients and their doctors. When treatment is medically appropriate, patients should not be stuck waiting while their physician and insurance company fight through layers of paperwork. Other issues, including copay accumulators, network adequacy and step-therapy requirements that force patients to try less effective medications first, also need to be addressed. But no single proposal will solve every problem in healthcare. Idaho cannot single-handedly control hospital prices, prescription drug costs, federal mandates or workforce shortages.

But we can improve the parts of the system within our control. We should listen to patients who have struggled with insurance while dealing with serious health problems. We should listen to providers frustrated by administrative delays, and we should listen to insurers who are trying to control rapidly rising medical costs.

Then we need to find solutions that are fair to everyone.

If we want Americans to continue believing that private health insurance is better than a government-run alternative, then private insurance has to work better. Idaho has an opportunity to help make sure it does.