Last week, Washington and Oregon were two of the first six states to get initial (conditional) approval from the federal government for their plans to set up state-based insurance exchanges. Idaho is rapidly approaching a final decision point on whether to start.
An Oregon statement on the plan called Cover Oregon says: “Cover Oregon is a central online marketplace where individuals and small businesses can shop for and compare health coverage options and access financial assistance, starting in October 2013. Coverage for plans purchased through Cover Oregon will be effective January 1, 2014. Through Cover Oregon, individuals and families will be able to easily compare plans, see quality grades for carriers and plans, and access financial assistance to help pay for premiums.”
Doesn’t, in truth, sound much like tyranny, and actually sounds more like a free marketplace.
That aspect of it – the federal requirement for a setup notwithstanding – may have resonated with free marketeer Idaho Governor C.L. “Butch” Otter, who (a day after the federal approval for the neighbors) said he would support establishment of a state-run exchange in Idaho. (Failure to set one up on the state level would result in establishment of a federal-run program.) But actual setup takes action as well by the state legislature, and that’s where things get complicated, and political.
A comparable proposal died earlier this year in the legislature but, partly because of personnel changes, chances may be better in 2013. An early spate of news stories on key players in the health and welfare committees suggest the proposal has at least a reasonable chance of getting to the floor in either chamber.
But whether it passes remains an open question, and so is its impact on Idaho Republican politics.
The insurance exchange easily could turn into a purity test for Idaho conservatives, with “squishes” – presumably including, improbably, Otter – being distinguished from the purists who simply say: hell no. It might (we don’t know yet if it will) pit parts of Republican leadership (not all of it) against large parts of the caucuses. It could split Republican leaders against each other.
An exchange battle could have an early effect on the elections in 2014 as well. Representative Raul Labrador doesn’t have any direct involvement with state legislating, and health insurance is outside the normal turf for Superintendent of Public Instruction Tom Luna, but watch closely to see if either of them speak out about a state-based health exchange, especially if against it. That could turn into an early indicator of a gubernatorial challenge for governor, either against Otter or his close ally and lieutenant Brad Little. (At least one Republican legislator last week was overheard saying that after his exchange announcement, Otter can’t win the Republican nomination for another term.)
Idaho could move in a simpler manner by copying pieces of other states’ plans, adapting them as preferred, or it could try – a much more complex effort – to reinvent the wheel. If time gets tight, Idaho officials may find it practically easier to do the first, but politically easier to do the second.
A fly on the wall of the upcoming Republican caucuses would be rewarded with entertaining listening.Share on Facebook