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idaho RANDY
The Idaho

No one living in Idaho or in other states should be unaware how the cost of health care, and insurance for it, has ballooned in the last few decades, driving people into individual ruin and straining businesses and other organizations (and economic recovery). A brush with a hospital is flirtation with bankruptcy – and it has meant bankruptcy for many. That’s true even for the insured, who find their protections eroding each year. And the number of uninsured sits at about 16 percent of all people nationally, 18 percent in Idaho (21 percent among those 64 and younger). This is an enormous problem.

There is no one cause and no one answer. One tactic intended to help, one that makes use of a marketplace, is an insurance exchange: An organization allowing buyers of insurance to shop around, compare costs and benefits and get assistance, in a way they haven’t been able to. Such a plan was built into the 2010 Affordable Care Act, and in it states were given the option to set up exchanges.

That’s the background for House Bill 248, which would establish by the state of Idaho an exchange aimed at helping consumers of health insurance to locate and buy appropriate policies. Alternatively, the feds would establish one in Idaho. The bill passed 41-29, after more than seven hours of debate.

You might suppose that long debate, one of Idaho’s longest legislative debates in decades, would have centered on the problems and costs of health care and insurance. You would suppose wrong.

The bill’s stated “purpose and intent” begins, “It is the public policy of the state of Idaho to actively resist federal actions that would limit or override state sovereignty under the 10th amendment of the United States constitution. Through this legislation, the state of Idaho asserts its sovereignty …”

That framing overwhelmed the debate. The need of Idahoans for affordable health care and insurance, whether the exchange was a good solution, whether this specific model might be improved upon: These were touched upon almost not all. The course of debate suggested the health (in effect, the safety) of Idaho’s people wasn’t of significant interest. Maybe the closest graze came from the conservative Representative JoAn Wood, who aptly noted the absence of strong consumer protections in the bill. The “sovereignty” of Idaho seemed the lone general concern – that, and taking potshots at anyone federal.

There were a few somewhat contrary voices on sovereignty, such as Representative Frank Henderson of Post Falls who noted how local governments often work with federal requirements without much trouble. And Representative Neil Anderson, R-Blackfoot, who delivered one of the most courageous debates in the Idaho Legislature in years by declaring “We are still the United States” and that the federal government should be seen as a partner, while instead “we’ve almost wound up in this adversarial role.” (Will he be thrown out of the House Republican caucus for that heresy?)

In those hours of debate, talk of wolves and roadless areas (in the context of federal and state control) roamed free. The only health-related specific subject was abortion, more precisely abortion-related “freedom of conscience” (for people opposed to abortions, not those seeking to have them).

Health care? Crushing financial catastrophe? The well-being of Idahoans and their ability to live in some measure of financial security? Evidently, not the Idaho Legislature’s concern.

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