BOISE, Idaho (AP) — Gov. C.L. "Butch" Otter was told Friday he should quickly enact a nonprofit, state-based insurance exchange under President Obama's health care overhaul.
The recommendation emerged from a panel created by Otter to advise him on Idaho's options after the U.S. Supreme Court upheld the disputed law.
Under Obama's 2010 Patient Protection and Affordable Care Act, states can establish online marketplaces for uninsured individuals and small businesses to compare and shop for insurance products. Alternatively, they can partner with the federal government — or let an exchange be run from Washington, D.C.
Kevin Settles, a Boise restaurant owner, voted with the panel's 10-2 majority, arguing a state-based exchange helps Idaho maintain control of its insurance market and develop products that meet individual and small-business needs while still keeping costs in check.
"We can make it reflect Idaho," said Settles, who owns Bardenay restaurants in Boise, Eagle and in Coeur d'Alene. "We can make it lean and mean."
Otter can't dally long if he accepts the recommendation, since there's a looming Nov. 16 deadline for states to notify the federal government of their intentions.
Spokesman Jon Hanian said after the vote that the Otter could act via executive order, but he declined to detail the Republican governor's plans.
Otter couldn't be reached; he was traveling in northern Idaho.
Though Otter isn't bound by the recommendation, Friday's vote was a victory for, in particular, insurers such as Blue Cross of Idaho, Regence Blue Shield and PacificSource that have spent tens of thousands or more on lobbying to promote a state exchange.
"We're very pleased ... that Governor Otter's working group supports the creation of a state-based exchange," said Heidi Low, a lobbyist for the Idaho Health Exchange Alliance, which includes the insurers.
Meanwhile, a libertarian-leaning panelist, the Idaho Freedom Foundation's Wayne Hoffman, urged doing nothing as an ideological show of defiance to Washington, D.C.
Adopting a state exchange simply invites more "federal tyranny," Hoffman argued.
"It's more the relationship of an abuser to a spouse," he said. "We keep getting beat up by the federal government — and we keep running back."
State Rep. Lynn Luker, R-Boise, suggested Idaho could postpone a decision until after the Nov. 6 election or longer. Republican presidential candidate Mitt Romney has vowed to upend what's derisively called "Obamacare" by its foes.
"There's no rush," Luker said.
He added if Otter issues an executive order for a state exchange, he'll engender hostility from members of the Idaho Legislature who only two years ago passed a law requiring Idaho to sue the federal government over Obama's overhaul. It might even violate that law, the Idaho Health Care Freedom Act, Luker said.
But Tom Shores, an independent health insurance broker from Boise, countered that Obama's overhaul — like it or not — had been upheld by a majority of Supreme Court justices in June.
Banking on Romney is just another way to put off what's necessary, Shores suggested.
"That's folly," he said. "It is the law, whether we like it or not."
There have been conflicting opinions of whether Idaho even has time to complete a state-designed exchange by Jan. 1, 2014, as required by the federal law.
On Oct. 9, for instance, experts hired by the state said Idaho's only option was to partner with the federal government on a hybrid exchange, as time had run out on going it alone.
On Friday, however, another consultant said Idaho still had time.
Idaho can build a state-based exchange, using some $30 million in aid from the federal government, "if you aggressively go after it," said Brett Graham, of Leavitt Partners in Utah.
A separate, Otter-appointed panel considering another provision of the health care overhaul — whether Idaho should expand its Medicaid program to cover more low-income people — is due to meet again on Nov. 9.