© 2022 Boise State Public Radio
NPR in Idaho
Play Live Radio
Next Up:
Available On Air Stations
Idaho's state-run health insurance exchange is expected to begin enrollment by Oct. 1, 2013 and fully functional by Jan. 1, 2014. The exchange is an online marketplace where Idahoans will be able to shop for and purchase health insurance. The Idaho Legislature approved plans to build the exchange in March 2013, but two years of intense debate preceded the vote.After the U.S. Supreme Court upheld the Obama Administration's federal health care overhaul in 2012, two key decisions rested with states. One, should states expand Medicaid to include more people? Two, should states create their own health insurance exchanges?Gov. C.L. "Butch" Otter chose not to make a snap judgement, instead, he created a work group to study whether Idaho should create it's own health insurance exchange, let the federal government create one for the state, or some combination of the two options.Otter's 14-member panel decided in October 2012 that Idaho should move forward with creating it's own exchange. The governor followed suit, and Gov. Otter issued a statement on Dec. 11, 2012 that Idaho should create a state-based exchange. Two Years Of DebateThe health insurance exchange debate has been ongoing ever since it became clear an exchange would be part of the federal health care reform package which was signed into law in 2010.Because Idaho didn't have the framework set up for a health insurance exchange, it was expected to be one of the biggest debates of the 2012 legislative sessionThe Associated Press held a special discussion of the issue during its January 2012 legislative preview. In a series of interviews that StateImpact conducted in December, legislator after legislator predicted it would be a defining issue of the months ahead.Instead, it was more or less dead on arrival. Not even a plan developed by Sen. Dean Cameron (R-Rupert) and Rep. Fred Wood (R-Burley) for a stripped-down, state-run exchange could muster sufficient support.Health insurance exchanges are a primary component of the Affordable Care Act. By their most basic description, exchanges are organizations — essentially online marketplaces — intended to make health insurance options more clear and, thereby, more competitive.The underlying logic is this: individuals and small businesses don’t have perfect information or a great deal of bargaining power with insurers. A health insurance exchange lays out the private and public health insurance options, explaining plans in terms of benefits and costs.Under the Affordable Care Act, states can create their own exchanges or wait for the federal government to do it for them.Rep. Wood says it was ideological opposition to the health care law that did in the prospects for a state-run exchange. “I think there was a certain number of people that simply didn’t want anything to do with an exchange,” he said. “And they were in a position that they could affect that outcome. In other words: no exchange.”Wood, a retired physician and former director of the Cassia Regional Medical Center, believes state lawmakers are rolling the dice, hoping the federal health care law will be overturned. “They’re betting that the Supreme Court will strike down the entire law,” he said. “And if we bet the wrong way, it could be very costly for the state.”Costly because states creating their own exchanges will have some discretion to set the essential benefits that must be provided by insurers. But states falling under the federal plan likely won’t have that same flexibility. The Idaho Department of Insurance has predicted Idaho employers could expect to pay millions more in health care costs under a federal exchange.

Blue Cross Of Idaho Asks For Rate Hike, Says More People Are Using Health Care


As Idaho gets ready for the third year of using a state health exchange under the Affordable Care Act, insurance companies are still adapting to the new system. This month, those companies announced some proposed rate increases for insurance policies next year.

The Associated Press reported last week that Blue Cross of Idaho has asked for the most rate hikes.

“[That’s] simply because we offer more plan options for people,” says Josh Jordan, manager of Corporate Communications with Blue Cross of Idaho. He says every insurance carrier in the state asked for increases.

Jordan says the average rate increase for individual Blue Cross plans in 2016 is 24 percent. Last year, the price hike was nine percent. He says there are a variety of things affecting prices.

“More people have health insurance in the individual market in Idaho than have ever had it before,” says Jordan. “That’s a really good thing. So those people have tended to have a higher utilization maybe than our existing or previously insured members or than we were anticipating.”

He says the high utilization of services shows people who got insurance, needed it.

“Hopefully it can help people in their health,” he says.

Jordan says the rate increases are not limited to Blue Cross or to Idaho.

“Across the nation, Idaho actually is nowhere near the top," he says. "You’re seeing rates across the nation in the 30, 40, even 50 percent increase range.”

Jordan says the Affordable Care Act addressed health care reform by increasing access. It also increased some of the services that health insurers needed to cover on their plans.

“One thing it has not addressed is the underlying causes of these increased utilizations, things like health and wellness,” Jordan says. “Why is it people are needing more and more services. It’s also not addressing anything about cost. Those are things the health industry is going to have to deal with going forward.”

Jordan says for every $1 Blue Cross is bringing in in premiums, it’s paying roughly $1.08 out in claims. “Whether you’re a person, a company, or a country, spending more money than you take in is going to lead to some financial problems,” he says.

Jordan says higher insurance prices could push some people off insurance. But he says subsidies through the Affordable Care Act can help. And having more people on Idaho’s health exchange would help.

“Cost is always a concern, we understand that. People have to make the right decisions for them," Jordan says. "We do everything we can to keep it to the lowest prices possible.”

Josh Jordan says any increase in insurance rates must be approved by Idaho’s Department of Insurance.

Currently, Blue Cross of Idaho has 49,792 people enrolled in coverage plans through Idaho’s health care exchange. Blue Cross serves more than 89,000 people with plans, both on and off the exchange.

Find Samantha Wright on Twitter @samwrightradio

Copyright 2015 Boise State Public Radio

As Senior Producer of our live daily talk show Idaho Matters, I’m able to indulge my love of storytelling and share all kinds of information (I was probably a Town Crier in a past life!). My career has allowed me to learn something new everyday and to share that knowledge with all my friends on the radio.