Governor C.L. "Butch" Otter announced today that Idaho is opting for a state-based health insurance exchange under the terms of Obamacare, subject to legislative approval.
"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."