{"id":12541,"date":"2012-10-31T14:50:37","date_gmt":"2012-10-31T20:50:37","guid":{"rendered":"http:\/\/stateimpact.npr.org\/idaho\/?p=12541"},"modified":"2012-10-31T17:28:14","modified_gmt":"2012-10-31T23:28:14","slug":"fear-of-rising-health-care-costs-drives-health-exchange-recommendation","status":"publish","type":"post","link":"https:\/\/stateimpact.npr.org\/idaho\/2012\/10\/31\/fear-of-rising-health-care-costs-drives-health-exchange-recommendation\/","title":{"rendered":"Fear Of Rising Health Insurance Costs Drives Health Exchange Recommendation"},"content":{"rendered":"<div id=\"attachment_11474\"  class=\"wp-caption module image right\" style=\"max-width: 300px;\"><a class=\"fancybox\" title=\"A working group appointed by the governor last week recommended that Idaho aim to have a state-based health insurance exchange up and running by 2014.\" href=\"http:\/\/stateimpact.npr.org\/idaho\/files\/2012\/09\/Stethescope-and-Chart.jpg\" rel=\"\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-11474\" title=\"Stethoscope and Chart Doctor Shortage\" src=\"http:\/\/stateimpact.npr.org\/idaho\/files\/2012\/09\/Stethescope-and-Chart-300x183.jpg\" alt=\"\" width=\"300\" height=\"183\" srcset=\"https:\/\/stateimpact.npr.org\/idaho\/files\/2012\/09\/Stethescope-and-Chart-300x183.jpg 300w, https:\/\/stateimpact.npr.org\/idaho\/files\/2012\/09\/Stethescope-and-Chart-620x378.jpg 620w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a><p class=\"wp-media-credit\">Emilie Ritter Saunders \/ StateImpact<\/p><p class=\"wp-caption-text\">A working group appointed by the governor last week recommended that Idaho aim to have a state-based health insurance exchange up and running by 2014.<\/p><\/div>\n<p>When Idaho Association of Commerce and Industry President Alex LaBeau made his ultimately successful motion that the <a title=\"Idaho\u2019s Health Insurance Exchange Group Makes Recommendation; Decision Now Rests With Gov. Otter\" href=\"http:\/\/stateimpact.npr.org\/idaho\/2012\/10\/26\/idahos-health-insurance-exchange-group-makes-recommendation-decision-now-rests-with-gov-otter\/\" target=\"_blank\">Health Insurance Exchange Working Group<\/a> should call for Idaho to implement a state-based exchange by 2014, he spoke in dramatic terms.<\/p>\n<p>&#8220;What is in the best interest of the employers in the state of Idaho?&#8221; he asked.\u00a0 &#8220;How can we mitigate this massive increase in their costs that\u2019s coming?\u00a0 The only way is to pursue a state-based exchange.&#8221;<\/p>\n<p>Health insurance exchanges are a key component of the federal health care law.\u00a0 Essentially, they\u2019re marketplaces that allow consumers to evaluate and purchase health insurance. Gov. C.L. &#8220;Butch&#8221; Otter convened his 13-member working group after the U.S. Supreme Court upheld the federal Affordable Care Act earlier this year, forcing states to decide what form of exchange to pursue.\u00a0 <!--more--><\/p>\n<div class=\"related-content alignleft\"><h4 class=\"related-header\">Related<\/h4><div class=\"links\"><h5>Posts<\/h5><ul><li class=\"link\"><a href=\"http:\/\/stateimpact.npr.org\/idaho\/2012\/10\/26\/idahos-health-insurance-exchange-group-makes-recommendation-decision-now-rests-with-gov-otter\/\">Idaho&#8217;s Health Insurance Exchange Group Makes Recommendation; Decision Now Rests With Gov. Otter<\/a><\/li><li class=\"link\"><a href=\"http:\/\/stateimpact.npr.org\/idaho\/2012\/10\/09\/another-expert-tells-stakeholders-idaho-has-run-out-of-time-to-build-health-insurance-exchange\/\">Another Expert Tells Stakeholders Idaho Has Run Out Of Time To Build Health Insurance Exchange<\/a><\/li><li class=\"link\"><a href=\"http:\/\/stateimpact.npr.org\/idaho\/2012\/09\/27\/idahos-medicaid-expansion-workgroup-explores-three-options\/\">Idaho&#8217;s Medicaid Expansion Workgroup Explores Three Options<\/a><\/li><li class=\"link\"><a href=\"http:\/\/stateimpact.npr.org\/idaho\/2012\/08\/30\/idaho-health-exchange-group-hears-from-prominent-foes-of-the-federal-health-care-law\/\">Idaho Health Exchange Group Hears From Prominent Foes Of The Federal Health Care Law<\/a><\/li><li class=\"link\"><a href=\"http:\/\/stateimpact.npr.org\/idaho\/2012\/08\/02\/it-would-be-a-miracle-if-state-meets-health-insurance-exchange-deadline\/\">It Would &#8220;Be A Miracle&#8221; If State Meets Health Insurance Exchange Deadline<\/a><\/li><li class=\"link\"><a href=\"http:\/\/stateimpact.npr.org\/idaho\/2012\/07\/10\/gov-otter-favors-further-study-of-health-care-decision\/\">Gov. Otter Favors &#8220;Further Study&#8221; Of Health Care Decision<\/a><\/li><li class=\"link\"><a href=\"http:\/\/stateimpact.npr.org\/idaho\/2012\/06\/29\/supreme-court-ruling-means-decisions-ahead-for-idaho-lawmakers\/\">Supreme Court Ruling Means Decisions Ahead For Idaho Lawmakers<\/a><\/li><\/ul><\/div><div class=\"topics\"><h5>Topics<\/h5><p class=\"topic\"><img class=\"alignleft\" src=\"http:\/\/stateimpact.npr.org\/idaho\/files\/2012\/06\/CapitolDome_ARTSY_ERS.jpg\" height=\"60\" width=\"60\" \/><a href=\"http:\/\/stateimpact.npr.org\/idaho\/topic\/health-insurance-exchange-2\/\">Idaho&#8217;s Health Insurance Exchange Debate<\/a><\/p><\/div><\/div>\n<p>There are reasons for states to implement their own health insurance exchanges.\u00a0 A draft report from the working group outlines many of them, and they boil down to this: a state-based exchange allows Idaho to retain greater control over its health insurance market.<\/p>\n<p>LaBeau\u00a0<del><\/del>says there are specific aspects of the Affordable Care Act that could drive up health insurance costs in Idaho.\u00a0 For example, the health care law limits the extent to which insurers can raise premiums based on things like health status, age and gender.\u00a0 LaBeau believes that could result in higher premiums for healthy people.<\/p>\n<p>There&#8217;s also the issue of what the ACA terms &#8220;essential health benefits.&#8221;\u00a0 Those essential health benefits are, basically, a minimum level of coverage that health insurance plans must meet.\u00a0 Whatever benefit level is established as the benchmark will have implications for health insurance costs.<\/p>\n<p>Late last year, the U.S. Department of Health and Human Services <a href=\"http:\/\/www.hhs.gov\/news\/press\/2011pres\/12\/20111216c.html\" target=\"_blank\">granted states greater-than-expected leeway<\/a> to determine what the essential health benefits package will include.\u00a0 Nevertheless, LaBeau believes there&#8217;s a chance Idaho could lose the ability to set that benchmark under a federally-run exchange, or under a federal-state partnership exchange.<\/p>\n<p>According to Larry Levitt, a senior vice president at the <a href=\"http:\/\/www.kff.org\/about\/index2.cfm\" target=\"_blank\">Kaiser Family Foundation<\/a>, both of LaBeau&#8217;s concerns are misplaced.\u00a0 Yes, the limits on premium discrimination could slightly elevate costs for healthy individuals or groups.\u00a0 But it should also bring <em>down<\/em> insurance costs for those who are less healthy.\u00a0 In other words: it should all come out in the wash.<\/p>\n<p>Moreover, Levitt says, there&#8217;s no reason to think states will not be able to establish their essential health benefits packages based on insurance plans currently offered in their state.\u00a0 &#8220;What the guidance said was that if a state does not choose the essential benefit benchmark, the benchmark will still reflect what the mandated benefits are in the state,&#8221; Levitt says.<\/p>\n<p>\u201cThe state decisions around creating health insurance exchanges are so colored by ideology and politics that in a lot of cases the debates are not entirely based on the facts,&#8221; he observes.\u00a0 Still, Levitt says, those arguments are in some cases deployed to spur action that may well be in states&#8217; best interest.<\/p>\n<p>\u201cWhen push comes to shove, I don\u2019t think there are many states that are going to want the federal government coming in and overseeing their insurance markets,\u201d he says.<\/p>\n<p>Working group member Zelda Geyer-Sylvia, executive vice president and CEO of Blue Cross of Idaho, says that&#8217;s the high-level argument for pursuing a state-based exchange.\u00a0 States still haven&#8217;t received the full rules and regulations pertaining to health insurance exchanges, she notes.\u00a0 Once that guidance becomes available, it&#8217;s still subject to change.\u00a0 A state-based exchange is the one that offers stakeholders the greatest influence, and therefore the greatest opportunity to control costs.<\/p>\n<p>&#8220;I think we will have some control over how new products are developed in the exchange if we maintain it on the state level,&#8221; Geyer-Sylvia says.\u00a0 She gives an example.\u00a0 &#8220;Say I&#8217;m a family with young kids,&#8221; she says.\u00a0 &#8220;I might want lower out-of-pocket cost to see my physician, and I might want a higher out-of-pocket cost for an inpatient hospital stay.&#8221;\u00a0 An older person, however, might want the opposite.<\/p>\n<p>Under a state-based exchange, Idaho insurers would presumably have greater leeway to develop health care products that match local demands. &#8220;How you piece those things together will be very important, and that&#8217;s the flexibility we want,&#8221; Geyer-Sylvia says.<\/p>\n<p>The Department of Insurance released <a href=\"http:\/\/www.doi.idaho.gov\/HealthExchange\/Final_report.pdf\" target=\"_blank\">the working group&#8217;s findings and recommendations<\/a> today.\u00a0 The final decision <a title=\"Idaho\u2019s Health Insurance Exchange Group Makes Recommendation; Decision Now Rests With Gov. Otter\" href=\"http:\/\/stateimpact.npr.org\/idaho\/2012\/10\/26\/idahos-health-insurance-exchange-group-makes-recommendation-decision-now-rests-with-gov-otter\/\">rests with the governor<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>When Idaho Association of Commerce and Industry President Alex LaBeau made his ultimately successful motion that the Health Insurance Exchange Working Group should call for Idaho to implement a state-based exchange by 2014, he spoke in dramatic terms. &#8220;What is in the best interest of the employers in the state of Idaho?&#8221; he asked.\u00a0 &#8220;How [&hellip;]<\/p>\n","protected":false},"author":46,"featured_media":11474,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[15],"tags":[235,27,119],"acf":[],"_links":{"self":[{"href":"https:\/\/stateimpact.npr.org\/idaho\/wp-json\/wp\/v2\/posts\/12541"}],"collection":[{"href":"https:\/\/stateimpact.npr.org\/idaho\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/stateimpact.npr.org\/idaho\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/stateimpact.npr.org\/idaho\/wp-json\/wp\/v2\/users\/46"}],"replies":[{"embeddable":true,"href":"https:\/\/stateimpact.npr.org\/idaho\/wp-json\/wp\/v2\/comments?post=12541"}],"version-history":[{"count":1,"href":"https:\/\/stateimpact.npr.org\/idaho\/wp-json\/wp\/v2\/posts\/12541\/revisions"}],"predecessor-version":[{"id":12599,"href":"https:\/\/stateimpact.npr.org\/idaho\/wp-json\/wp\/v2\/posts\/12541\/revisions\/12599"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/stateimpact.npr.org\/idaho\/wp-json\/wp\/v2\/media\/11474"}],"wp:attachment":[{"href":"https:\/\/stateimpact.npr.org\/idaho\/wp-json\/wp\/v2\/media?parent=12541"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/stateimpact.npr.org\/idaho\/wp-json\/wp\/v2\/categories?post=12541"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/stateimpact.npr.org\/idaho\/wp-json\/wp\/v2\/tags?post=12541"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}