A Coeur d'Alene legislator tapped with analyzing the implementation of the Affordable Care Act has doubts about a state insurance exchange.
Sen. John Goedde is among 12 Idaho lawmakers and health insurance experts selected for a committee that will recommend how Idaho should carry out aspects of President Obama's new health care reform.
Cobbled by Gov. Butch Otter, the group is tasked with weighing whether Idaho should create its own health insurance exchange, or participate in a federally run version.
The reform only allows for one or the other, Goedde said.
There are ostensible challenges to both, he added.
"When I returned from (health care related) meetings last November, I totally supported implementation of a state exchange. And now with more information coming forward, I guess I've got a less clear path," Goedde said. "I think the governor has those same concerns, that there's a wealth of information and misinformation floating around right now, and we need to sort through that before any recommendations come forward."
He couldn't hazard a guess on which way the whole committee would lean.
But recommendations will have to be made soon, he said, noting that marketplaces to buy government-subsidized insurance will be up and running by 2014.
"It's a huge task when you look at just the bulk of the legislation, and trying to understand how state exchanges and federal exchanges are going to work," he said.
Structurally, both exchanges would basically be the same, said Goedde, licensed to sell insurance.
He sees a significant downfall to allowing a federally operated exchange in Idaho, he said.
As he understands it, the state would have no input on the exchange's operation, he said.
"We would take what they give us, which as I understand it is a fairly liberal benefits package," Goedde said.
A federal exchange could negatively affect health insurance companies in Idaho, he added.
Insurance agents' commissions might be reduced due to changes in the cost of overhead, he predicted. Federally hired insurance navigators might provide wrong information to consumers, he said.
"It appears to me to be an invitation to disaster," Goedde said.
But the option of a state-run system also looks to flirt with major problems.
"There's going to be all kinds of challenges, not the least of which is the expense to the state," he said. "The state that's financially strapped, even though we did well in the last budget year. It's going to have a huge impact."
The first meeting of the committee, to be led by Idaho Department of Insurance Director Bill Deal, has not been scheduled yet.
The governor has also created another committee, comprised of 14 government officials and health care experts, to evaluate possible impacts of the reform's expansion of Medicaid benefits.
The benefits would stretch to cover citizens with incomes up to 138 percent of the poverty level.
Ideally, both committees will make recommendations "as quick as humanly possible," said governor spokesman Jon Hanian.
"They're cognizant of the fact that we really need to make some decisions," Hanian said.
The chief motivation for the committees is to address the myriad questions still surrounding the new health care act, Hanian said.
"There are a lot of questions about many of the rules and regulations that Obama's law has established," he said, noting rumored fees for accessing insurance exchange data. "To say this is a sweeping change is an understatement. I think the governor felt he wanted to proceed very cautiously and carefully to consider all of those issues as Idaho formulates its answer."