Gov. Otter and the Idaho departments of Health and Welfare and Insurance recently asked the Idaho Legislature to approve implementation of the Idaho Health Care Plan. The plan has raised a number of good questions, and I would like to try to answer some of them.

First, Gov. Otter deserves credit for being one of America’s most creative and courageous governors. He has nothing to gain politically by advancing the Idaho Health Care Plan but is simply working to provide hardworking Idaho families with reasonable solutions to the high cost of health insurance.

The governor actually has two separate and independent proposals aimed at different parts of the problems created by the federal Affordable Care Act — better known as Obamacare. The two proposals address different populations but have the same goal — lowering the cost of health insurance and stabilizing the individual insurance market. Both focus on Idahoans who have been priced out of the market and those who are left out of assistance and both are needed to reduce rates and stabilize the market.

The Idaho Health Care Plan focuses on Idahoans who have serious end-of-life, complex medical conditions and those who do not have enough income to qualify for federal assistance. It requires legislative approval, through House Bill 464, to enable the state to apply to the U.S. Department of Health and Human Services for waivers from Obamacare requirements. It has two components which work together to offset costs.

The first, called the 1115 waiver, allows Idahoans with certain serious health conditions the ability to apply for Medicaid. This is similar to the current breast and cervical cancer program. Allowing about 2,500 Idahoans with these complex medical conditions access to Medicaid will reduce the amount paid in claims by an estimated $200 million, which in turn will reduce insurance rates by 20 percent for all who buy insurance in the individual market.

While it allows about 2,500 Idahoans access to Medicaid, the 1115 waiver proposal falls short of what critics call Medicaid expansion. Expanding Medicaid would not require an HHS waiver. We would simply be mandating Medicaid coverage of a certain population based on income and would receive additional federal funding to do so. We are doing neither.

The second component of the Idaho Health Care Plan, called a 1332 waiver, helps Idahoans who have been left out — Idahoans who do not make enough to qualify for the federal subsidy on premium costs provided in Obamacare. The 1332 waiver addresses the ACA rule granting assistance with insurance costs to those with incomes at 100 percent of the federal poverty level or more, but no assistance to those with incomes below 100 percent of the federal poverty level. It also addresses the unfairness of the ACA rule that provides assistance to legal residents who are not citizens if their incomes are below 100 percent of poverty, but no help for Idaho citizens at the same income level.

The governor and I believe health insurance is too expensive. We also believe Obamacare leaves the people of Idaho with too few reasonable coverage options. With the Idaho Health Care Plan, we are doing our best to protect Idaho’s working families.

If you agree, please call or email your legislators and ask them to support the Idaho Health Care Plan, House Bill 464. Together, we can make a real difference.

Dean Cameron is the director of the Idaho Department of Insurance.

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