The exchange excuses: the Idaho legislative debate that wasn't

While nine U.S. Supreme Court justices are scrutinizing the federal health care law, 105 Idaho legislators and one governor have done one of those things they do well.

They are ducking a tough issue. In this case, the creation of a health insurance exchange.

Remember the health insurance exchange? This was one of those issues that was supposed to keep the Legislature busy until adjournment. The idea never even got a hearing — partly because the Supreme Court gave some legislators a perfectly handy excuse.

When lawmakers arrived in Boise in January, they also knew the Supreme Court would spend the last week of March hearing oral arguments over the law some Republicans prefer to call “Obamacare.” And that became one of the arguments for doing nothing. Why establish a health insurance exchange, as required under the federal law, if the Supreme Court might declare the entire law unconstitutional?

Well, fine, except for this. Thanks to the politics of avoidance, this Legislature will have done nothing to address the needs of individuals and small businesses that cannot find or afford insurance. That’s 19.2 percent of the state’s population, a considerable cohort. Many of these uninsured Idahoans would probably use a marketplace where they can shop for coverage — no matter where the Supreme Court comes down on the “individual mandate,” the much-debated linchpin of the federal health care law.

And that’s the problem. The health exchange issue became conjoined with the furor over the federal health care law. Part of that is unavoidable; there was, of course, the matter of accepting $20.3 million in federal health care money to establish an Idaho exchange. But opponents of an Idaho exchange have sought to capitalize as much as they can on the unpopularity of “Obamacare” — as evidenced by House Health and Welfare Committee Chairwoman Janice McGeachin, R-Idaho Falls, and her Statehouse “Bible sessions” to bring together people to read excerpts of the law.

Lost in all the commotion is the fact that a gubernatorial task force recommended the creation of a health exchange.
In 2007.

Five years ago.

This was the year when Gov. Butch Otter seemed prepared to follow up on his task force’s recommendations and push for a health insurance exchange. But when it came down to pressing for an initiative he claimed to support, his arguments and follow-through were half-hearted. Otter never seemed terribly interested in getting a state-run exchange moving — before 2014, when, under the federal health care law, the feds can come in and establish their own framework.

This is a governor who has had little success trying to lead legislators where they don’t want to go, as best illustrated by the first-term drubbing he took when he sought gasoline tax and vehicle registration increases to bankroll highway repairs. The health exchange might have been an even tougher fight, and possibly a futile effort — but Otter didn’t seem to want to find out.

Showing no interest in pressing the issue, Otter seemed perfectly content to give lawmakers a second excuse for doing nothing. And when lawmakers are looking to avoid difficult work, any old excuse will do.

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Replace Obamacare with health care similar to France, which has the best by most analysts. If France is not the best, find one that is and use it as a model.

Not gonna happen

The idea of socialized healthcare is a non-starter for the Rs. It was against long odds that Obama got the ACA into law. When the Supremes knock down the mandate, or the whole ACA, we all can cheerfully return to; taking our kids off our insurance (mine are 21 and 23 and are on my insurance as they are employed but without benefits), letting insurance companies deny coverage for pre-existing conditions, insure that 50 million or so Americans go without insurance so the rest of us can pay for their inevitable use of healthcare, continue to see medical debt as a leading cause of bankruptcy, and watch our premiums grow year by year, forcing more and more businesses to drop insurance as a benefit, putting more and more Americans on the list of uninsured, setting up more bankruptcy and needless deaths from lack of follow-up care on diseases such as cancer and diabetes.

And this would be a good thing?

lacking leadership of course

What do you expect from these guys? Hey everyone will need health care some day. Why not all work together to pay for it, that way we can all afford it.

In defense of Obamacare

It is the President's signature issue and legacy so why shouldn't it bear his name?

Everyone knows what you mean when you say Obamacare whereas the legislation's official title is too wordy to write or repeat over and over in a discussion and the acronym is unintelligble.

you are right

The pres should be very proud of it. Affordable healthcare for everyone and we need it. Thank you president Obama!


Even the Obama administration is starting to say it.

Truth is hard to come by

you mean the ACA...

as it is commonly called?


"The Patient Protection and Affordable Care Act (PPACA), commonly called Obamacare...." (Source Wikipaedia)

On the pretext of protecting us from ourselves, there is nothing affordable about this Act.

We can't afford to go on the way we were

I have yet to see any ideas concerning healthcare from the Rs except shopping out of state for insurance (big deal) and of course, cutting taxes.

We have to change something because the system is broken.

I'm all ears.

Really? It's too hard to say ACA?

Come on. You are smarter than that.

American Correctional Association

Or could it be the American Chiropractic Association? Do you have any idea how many organizations ACA stands for?

You don't have the ability to understand context?

Again, you seem smart enough to know that, if an article about health reform refers to the ACA or PPACA, you would probably know what they are talking about. If the article is well-written and makes appropriate references there should be no confusion at all. Are you saying people can't figure out what we are talking about unless it is called Obamacare? If they are that inept, I wonder how they would understand the rest of the conversation. People use Obamacare because you want to make a point, not because ACA is too difficult to understand.

Personally, there was plenty about the Patriot Act that I found anything but patriotic but I still refer to it by its name.


Anyone who couldn't figure out that ACA refers to in a story about healthcare should be careful to not go to Vegas to buy electrical equipment because he heard the RCA was coming to town for the championship.

No need for context with Obamacare

I'm saying Obamacare is readily understood by everyone to be the President's legislation to reform the insurance industry. People immediately grasp what you are talking about with or without any context.

Additionally, I don't believe our nation can financially afford this program, and there is no evidence it will reduce the cost of health care or insurance premiums. Calling it the Affordable Care Act - note the word health does not appear in the official title - is misleading and deceptive.

Affordable Health Care

The name of the legislation is Affordable Health Care. The Republicans renamed it because it is pretty hard to go on record as saying you are opposed to affordable health care. Interestingly, many people in the media are using the Reupublican nomenclature instead of the correct name.........and the conservatives think the media is biased against them? The issue IS affordable health care. How do we assure that our health care is affordable and includes all? As I recall the Dems wanted a single payer system such as Medicare which has a lower administrative cost, but creates jobs in the public sector as opposed to the private sector. It was the Reps that wanted to make sure insurance companies were not cut out as the middle man. They seem to feel your health care should be controled by private companies rather than the government. At any rate they were the ones who wanted to keep insurance companies in the loop and now they are using our tax dollars to fight the insurance requirement in court. Go figure!

No health in PPACA

The word health does not appear in the title of this legislation.