Printed on: February 14, 2013
The lesser of two evils
Sean J. Coletti
The arguments against creating a state health insurance exchange don't hold up, writes Sean J. Coletti in an open letter to Idaho's legislators.
I have read through Senate Bill No. 1042, as well as provisions of the Patient Protection and Affordable Care Act covering health insurance exchanges, and would urge you to support the governor in his effort to establish a state-based exchange.
Bill No. 1042 establishes controls on the proposed exchange by the governor and Legislature, while separating the exchange from state government to avoid unnecessary costs to the state. This bill should be carefully considered as a method of implementing a state-based exchange in Idaho.
While some have suggested that Idaho should not create a state-based exchange, I think that would be a mistake. The federal and state exchanges are not entirely the same. I am convinced that Idaho would lose an element of control by simply accepting the federal exchange. Furthermore, we have an opportunity to craft an exchange that best fits the needs of Idaho.
There are also some who believe that if we decline a state-based exchange now, we can always set one up later. I believe it is much easier to draw the parameters of an Idaho state-based exchange now than it would ever be to convert a federal-based exchange in Idaho some years from now.
Some also believe that if we do not set up a state-based exchange, the federal government will give up on implementing Obamacare. I am not convinced that President Obama's administration, fresh off of an election victory, with a Democratic-controlled Senate, would give up on its signature accomplishment. Our Legislature would be wise to prepare for the worst by setting up the best state-based exchange possible. The federal government will set up its own cookie-cutter exchange if we don't act.
Finally, I have heard from some that we should not set up a state-based exchange based upon tax penalties certain employers may face for failing to follow the PPACA. The idea is that, based upon a glitch in the wording of the PPACA, a federal-based exchange would not have the power to issue such penalties. This position is shortsighted. The IRS is already preparing regulations which apply these taxes, regardless of the type of exchange.
This is a situation where we must make a decision between the "lesser of two evils." Policymakers often have to make these difficult decisions. I have never supported Obamacare, but, alas, it is here. I urge you to decide to make the best of it by setting up the best state-based, market-driven exchange possible for the state of Idaho.
It may not be the popular decision, but, given the circumstances we face, I believe it is the right one. Thanks for your time and efforts spent on behalf of our great state.
Coletti is an attorney at Hopkins Roden Crockett Hansen & Hoopes PLLC and also serves on the Ammon City Council.