Health Insurance Exchange Decision Rests With Gov. Otter, But Legislators Will Have Their Say

Emilie Ritter Saunders / StateImpact Idaho

Idaho is one of a dozen states that is still studying its options with respect to health insurance exchanges.

Gov. C.L. “Butch” Otter got a reprieve, if he wants it.  Friday, Nov. 16 was supposed to be the final day for states to tell the federal government whether they will set up their own health insurance exchanges.

It was a deadline established by the U.S. Department of Health and Human Services, to ensure the exchanges are online by 2014.  But Republican governors asked for more time, and yesterday they got it.

The Idaho Legislature does not convene again until early next year, so this decision still falls to the governor.  And if Gov. Otter follows the conclusions reached by his working group last month and determines that Idaho should build its own exchange, there’s little doubt the Legislature will also have to get on-board.

“Last I heard, he couldn’t just do an executive order and put it in place,” House Majority Leader Mike Moyle (R-Star) said last week, referring to the governor’s authority to settle on a state-based exchange.  Along with House Speaker Lawerence Denney (R-Midvale), Moyle has pushed for the state to “resist Obamacare,” and refuse to implement the Affordable Care Act.

Gov. Otter’s press secretary, Jon Hanian, declined to comment directly on Rep. Moyle’s view.  Several calls to the governor’s chief of staff, David Hensley, went unanswered.  The governor’s legal counsel, Tom Perry, also has not returned calls.

Former Idaho Attorney General David Leroy did agree to shed some light.  “The governor can certainly create an initiative, begin to put into place rudiments.  But eventually, because we’re going to be talking long-term, we will probably require statutes,” Leroy says.

He explains an exchange will also require money, which the Legislature must approve.  “Over the term that this enterprise takes to create, and over its functional life, certainly it will require the joint action of legislature and executive,” he says.

Sen. Dean Cameron (R-Rupert) — who owns an insurance company, co-chairs the Joint Finance-Appropriations Committee and the Legislative Health Care Task Force, and advocates a state-based exchange — agrees.  “At some point the Legislature will have to act,” he says.

And, if the governor does indeed support a state-based exchange, will the lawmakers who have resisted that decision come along?  Cameron believes so, though it may not happen easily.

“I can’t tell you how big of a battle that will be,” he says. “There certainly are those who are opposed. There will be some who will vote no to vote no.”

Still, Cameron doesn’t think that position will win out.

“The majority of the Legislature, I think, will be reasonable about it,” he says.  “And if that’s the way the governor decides to go, I think they will support it.”