Moving Idaho's State-Based Health Insurance Exchange Past Challenges

Statement

Of all the challenges we're facing with Idaho's state-based health insurance exchange, none have been more disappointing than the chorus of those who attribute each setback to cronyism or conspiracy, and those whose most constructive criticism is "I told you so."

When we run into a problem, Idahoans fix it. When we encounter difficulties, Idahoans overcome them. We always have, and we're working hard to do the same in this case.

There are no excuses for what's happened, but there are reasons. The fix is not easy, but it is straightforward. It involves doing the right thing and having checks and balances in place when the outcomes fall short or are off target. It's not perfect -- government seldom is -- and public-private partnerships can be clunky and even ugly early on. But they are essential in bringing Idaho's values and voices to bear.

First things first: The technology consulting contract awarded to a former Exchange board member was expeditiously and correctly voided last week. Yes, it should never have happened to begin with, but when it did the process worked.

Next, the admittedly delayed decision to form our own exchange left us with no real choice but to temporarily piggyback on what we were told was a working federal technology platform. It wasn't, and nobody can tell us with any level of authority or credibility when it will be working properly.

That's why I wrote U.S. Health and Human Services Secretary Kathleen Sebelius seeking at least a one-year delay in imposing the individual mandate for compliance with health insurance coverage requirements in the Affordable Care Act -- Obamacare.

Here's some of what I told her in my request:

"As you know, the State of Idaho has been working in good faith and with all responsible speed for the past 11 months to establish a state-based insurance exchange. I'm sure you also realize that the aggressive timeline for bringing the Idaho exchange online has necessitated our temporary use of federal technology -- technology that we all now are painfully aware lacks sufficient functionality to meet the needs of our citizens.

"While we appreciate the six-week delay in imposition of the individual mandate announced last week, with no resolution to the federal technology issues in sight it appears that six weeks will be woefully inadequate to the task of ensuring all Idaho consumers have the opportunity to enroll. Given the complexity of the issues involved and the troubled history we all have experienced, a nationwide delay until the federal technology is proven to meet the needs of our citizens is simply a matter of fairness.

"Granting at least a 12-month delay also will enable Idaho to complete development of a stand-alone technology platform for our state-based health insurance exchange and bypass the federal process. Together, those steps can help build public confidence in our Idaho efforts as reluctant and skeptical participants in this national enterprise."

They say the first step to getting out of a hole is to stop digging. Folks, we can stay mired in the would have/could have/should have of this situation and let our partisan or philosophical petulance overtake us, or we can focus instead on climbing out of this hole and asserting our Idaho independence and sovereignty by finishing the job we started last winter.

I choose to climb.

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