'With what we know today, this is our best option:' Otter backs state health exchange

UPDATED, 5:41 p.m., with comments from the Idaho Health Exchange Alliance, which supports the exchange.

Gov. Butch Otter says he will pursue a state-run health insurance exchange — setting up, potentially, a battle with legislative conservatives.

The exchange — an online marketplace allowing individuals and businesses to shop for health insurance — is a component of the federal health care law, opposed by Otter and legislative Republicans. But the law allows the federal government to impose an exchange in states that refuse to create their own exchange, an option noted by Otter in a news release today.

"Our options have come down to this: Do nothing and be at the federal government’s mercy in how that exchange is designed and run, or take a seat at the table and play the cards we’ve been dealt. I cannot willingly surrender a role for Idaho in determining the impact on our own citizens and businesses."

Otter last year expressed support of an exchange, which has long been backed by business groups. But Otter backed off amid legislative resistance.

States have a Dec. 14 deadline to announce whether they will pursue a state exchange.

My quick take: The fight isn't over.

First, the Legislature has to approve the exchange. Otter says he consulted with legislative leaders before making his decision.

Second, Otter even gives himself wiggle room. He says his decision can be rescinded "if circumstances warrant — a real possibility on such a constantly moving target.” It reads like a governor who felt he had to pursue an exchange, but not a governor who wanted to pursue one.

Here are Otter's comments, from a news release:

“This is not a battle of my choosing, but no one has fought harder against the mandates and overreaching federal authority of the Affordable Care Act. No one has more consistently and clearly demanded that Idaho retain the authority and flexibility to chart our own path forward. There was a judicial process for challenging Obamacare, and the presidential election was at least in part a referendum on its enactment. But despite our best efforts, the law remains in place, and almost certainly will for the foreseeable future. There will be a health insurance exchange in Idaho. The only question is who will build it.

"Our options have come down to this: Do nothing and be at the federal government’s mercy in how that exchange is designed and run, or take a seat at the table and play the cards we’ve been dealt. I cannot willingly surrender a role for Idaho in determining the impact on our own citizens and businesses.

“This decision does not signal support for the law or how it is being implemented. However, it does reflect my continued determination for Idaho to be actively engaged in making the best possible choices — to the degree we are allowed — in the interest of more accessible and affordable health care for our citizens.

“Obamacare is not the answer. In fact, it very likely will do little or nothing to reduce costs while force-feeding us coverage and increasing the size and scope of government. But it is an unfortunate and unwelcome reality, and it would be irresponsible of me to simply abandon the field to federal bureaucrats. In the face of uncertainty we must assert our independence and our commitment to self-determination while fulfilling our responsibility to the rule of law.

“The working group I assembled to study our options recommended this response. I greatly appreciate and respect the members of that panel their analysis, both the majority and those in dissent. I also consulted with national experts, many of my fellow governors and our own legislative leaders. I understand and empathize with those who would reject a role in this process, as some other states have done. I know that for many this is not a matter of consensus but rather of individual conscience, and I know the earnest and well-intentioned debate will continue.

“I take some comfort in the fact that even those disagreeing with this decision strongly believe as I do in Idaho’s ability to be more responsive and do a better job than the federal government alone of ensuring our citizens can make informed choices about their health care.

“All the criticisms of the exchange mandate that I and many others have expressed remain valid and troubling. The law is governed by an evolving set of increasingly complex rules and requirements. It is onerous, unwieldy and fraught with unknowns. That makes it all the more important to remember that my decision today can be rescinded if the Legislature disagrees or withdrawn by me if circumstances warrant – a real possibility on such a constantly moving target. But with what we know today, this is our best option.”

And from the opposition camp, here's a statement from Idaho Freedom Foundation Executive Director Wayne Hoffman. Hoffman was a member of an Otter task force that voted 10-2 to endorse a state exchange; Hoffman was one of the dissenters:

"I have a great deal of respect for my friend, Gov. Otter. However, I strongly disagree with his decision. More than 20 states have indicated that they will not implement a state exchange. States are opposed because they understand that Obamacare depends entirely on states to implement it. States are opposed because they know that a state exchange affords almost no flexibility and makes states co-owners of the looming disaster in medicine: higher insurance premiums, more expensive medical care, reduced accessibility and worse patient outcomes. Gov. Otter's decision makes the national effort of resistance much more difficult and more likely the law will remain in place, at great cost to Idaho families, businesses and our nation's economic vitality. Idaho Freedom Foundation will do everything it can, along with other opponents of Obamacare, to make sure Idaho never implements this destructive law."

The Idaho Health Exchange Alliance, a coalition of more than 400 businesses, individuals and trade associations, praised Otter's call. From executive director Heidi Low:

“We're very grateful that Governor Otter has shown Idaho the way forward on this issue. A state-based exchange will help Idaho have more control over Idaho's health insurance costs and keep Idaho in the driver's seat on health insurance issues. ...

“The governor's decision today allows Idaho to be actively engaged in making the best possible choices on behalf of its citizens. The Idaho Health Exchange Alliance appreciates his commitment to doing what is best for Idaho.”

1355272930 'With what we know today, this is our best option:' Otter backs state health exchange Idaho Statesman Copyright 2014 Idaho Statesman . All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

I don't see this being successful...

mostly because it's going to be implemented by Otter. I don't think that fella could mow my lawn correctly.


Whah, guess what, Butch.... you and your buddies lost!!!

You keep laughing

I hope you keep laughing it up...as it is obvious you don't know squat about the healthcare situation. The Pelosi mentality...pass the bill then we"ll figure it out late ...cuse we won.

"We" won? How bout we all voted and have to live with it?

Do you really think healthcare in its current state is ok? The Healthcare act certainly is not the solution but it does FORCE EVERYONE to address it.

Finally some leadership

Who know if the legislature will follow his leadership. A State Exchange is the best option for the State regardless what color you wear. We can't afford any of it...but at least the State has a say in the next four years with their own exchange.

No way

Butch, you were against the ACA. You were the first governor to file a lawsuit against it. Idaho therefore should get no benefit from a state exchange.


There was no way he could have pleased you....your comment is predictable as the sun coming up in the morning. Bad if he does bad if he doesn't...Get your buddies together and find a good candidate to replace him or move to Oregon or another state whose politicians march to your drum....Sheesh. Now.... I believe that it is better to have some local control than to have none. Do you have an argument for that....That comment was as valuable as the cr@@py business advice you gave me when I did not ask Have a pleasant evening know it all.....

For Crying Out Loud...

The thing that I dislike more than "big shot union bosses" is "big everything else". At the top of that list is insurance companies followed closely by government agencies. So a marriage between the two may be the worst of all possibilities. But, and this is really big but - bigger than Kim Kardashian's - is this new exchange might inject some desperately needed competion into the insurance and monsterously bloated local health care businesses.

Have you ever heard the expression

"it is better to keep silent and be thought a fool than to speak and remove all doubt"? If not, pay heed, as it's quite clear you have no idea how competitive the insurance business is. And it's far from bloated, but if you think it is, provide proof.


Thy own advise, this is uncharted territory and if you know everything please enlighten us. I would really like to hear your opinion if you are an expert. I am not doubting you, just asking you to expound on a light comment....


St Al's pays its administrator $1mil a year as does St Lukes plus or minus. Blue Coss does the same. Anytime an admistrator is paid that kind of money they must justify it in order to keep their job. That means they MUST increase revenue or get canned. That means YOUR med and insurance bills are jacked way up to cover increased revenue demands and beyond what it normally takes to find qualified people to do that kind of work. They are paid that because they know how to increase revenue and for no other reason. The top US Admirals, Generals and Cabinet secretaries make a little over $200K and supervise far larger work forces and budgets with hugely more important ramifications for poor performance. THINK!!!

Do you honestly think that

Do you honestly think that the Affordable Care Act, with all its rush & secrecy, really will allow self determination for Idaho if we set up an exchange? Either way, the federal government will be dictating the terms of our surrender. Better to show you stand by your principles, than to waffle like Otter has been lately.

Rush & Secrecy?

Yeah … starting with HillaryCare 20 years ago this just snuck up on ya, didn't it? Nothing in the news, no debates, not even any rumors … just a big surprise to the wazoohs.

This Clown Hoffman

speaks with such an aire of authority, predicting doom in the medical industry and the state's implication in it. What experience does he have that qualifies him as an expert on a health insurance exchange??? None! All he ever does is sit in the front row and throw darts at the people trying to get something done for their fellow citizens.

Thank you.

Now I can just briefly say, Wayne, you don't know the first thing about health care. Let the people who know what they are dealing with, deal with this.


Your resume? The system needs improvement but an "exchange" in any form will not make the program a success or remotely affordable. Not any more than what we presently have with all the shortcomings we presently have. Trade a lemon for a lemon and you still have a lemon.

what dog does he have in this fight?

but since his transparency organization doesn't reveal who funds it and pays his $80,000 salary, we'll never know.

Hoffman's Huff

WH's flabergastiation is nothing more than a piece of mustard stuck in his sclerotic craw.

He was on one of two "no" votes on the 12 member State's study group which by a 10 vote majority voted for an Idaho exchange. Since then he has claimed the panel was stacked by his good buddy BO..

His crystal ball into the future catastrophes in Obamacare are occluded by his rigid ideology.

I noticed that contributions to his non-partisan partisan (501 C3) IFF are dropping significantly. By falsely (and illegally) claiming the IFF is non-partisan, Hoffman has destroyed any remnant of its and his credibility

Goodbye Wayne. We've known you too long. Start the IFF petition for secession.

everyone who believes

that the Legislature, particularly the House, will ratify this, please poke out your right eye.

Not a problem...

The legislature can say no and Idaho gets a federally operated exchange. Actually, I expect the legislature will say no - they have a long history of short sighted thinkers.

If Gov. Otter had just led the way in the first place...

his charges in the legislature would have fallen into place and worked it out a lot sooner.

Move forward or sell the Studebaker for scrap!


Apple users, run the Gig of RAM your PC needs to have and read the dumb tech white papers, wrinkle your forehead and buy more food and toilet paper with the difference. The internet is a piece of junk anyway and your cats know this.