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Otter's exchange choice at Idaho lawmakers' mercy

John Miller, Associated Press

BOISE, Idaho (AP) -- Gov. C.L. "Butch" Otter's decision next week on what kind of insurance exchange the state should adopt remains at the mercy of lawmakers who return to Boise on Jan. 7 for the 2013 session, Republican legislative leaders said.

Otter has until Dec. 14 to tell the U.S. Department of Health and Human Services if Idaho plans to use federal financial help to create its own online marketplace for insurance products for individuals and small businesses or let the federal government install an exchange of its own.

The exchanges are a contentious part of President Barack Obama's health insurance overhaul in places like Idaho where many GOP lawmakers in 2010 equated the package with a shift toward socialized medicine. New House Speaker Scott Bedke told The Associated Press that Otter's decision will be the subject of debate — and potential rejection — by his representatives.

There are 25 new GOP House members, and he said he has yet to ask them what they think.

"We're trying to get a feel for where everybody is at on this," Bedke said. "I don't know what it's going to look like."

While he's closely aligned with lawmakers who favor a state-based exchange — including his newly-appointed House Health and Welfare Committee chairman, Rep. Fred Wood, R-Burley — Bedke said leadership won't be dictating a final decision.

That'll be up to the caucus, he said.

Bedke and Senate President Pro Tempore Brent Hill meet with Otter Friday to discuss the exchange dilemma.

Ahead of the meeting, Hill suggested the Republican governor should do nothing that limits legislators' room to maneuver.

That would likely mean following the Oct. 26 recommendation from a governor-appointed panel advising Otter to adopt a state-based, nonprofit exchange run by a private board. After all, legislators can always do an about-face and go with the federal exchange, but it doesn't work the other way.

"Then, we have all our options," Hill said.

Otter staffers didn't return a phone call Friday seeking comment.

Idaho insurers and business groups are pushing for a state exchange, on a variety of grounds.

Providers like Blue Cross of Idaho, Regence Blue Shield and PacificSource Health Plans fear a federal exchange would invite more intervention from Washington into currently state-regulated insurance markets. They also contend a federal exchange's policies would be costlier for customers than those from a state exchange tailored to meet Idaho residents' needs.

Already, lawmaker email inboxes are filling with these arguments.

"We have sent them several communications about our position," said Heidi Low, lobbyist for the Idaho Health Exchange Alliance, nearly 400 individuals and businesses pushing for a state-based exchange.

Rep. Robert Anderst, a new GOP lawmaker from Nampa on the receiving end of the mail, favors the concept of Idaho taking control of its own destiny, but he's not yet willing to say how he'd vote.

"There are so many questions left unanswered," Anderst said.

Idaho Republicans hoped the U.S. Supreme Court would reject the law. When that failed, they banked on GOP presidential candidate Mitt Romney winning on Nov. 6.

Now, Wood, Bedke's confidante and committee leader, says exchange foes need to quit placing their hopes on others.

"If you don't do anything, you're, in effect, inviting the federal government to come into Idaho," he said.

Last year, Wood's legislative plan for a state exchange never got a hearing under then-House Speaker Lawerence Denney, an ardent opponent of a federal exchange.

Though Denney, R-Midvale, was deposed as the top House lawmaker Wednesday, he and others oppose the federal law, which puts Otter "between a rock and a hard place."

"There are still a lot of people that are opposed to an exchange," Denney said. "I'm sure he has to consider that."