Second, Idaho’s House passed a bill this week creating a state-based insurance exchange.  The Senate had already passed one.

While not quite a done deal, this is nevertheless another big deal for at least two reasons.

1.  The federal deadline has passed for state’s to run their own exchanges, and which are eligible for premium subsides.  But the federal exchange effort is so widely off track right now that a sincere effort by a state like Idaho may be an effort CMS and HHS wants to support, regardless of previous deadlines.

2.  As Washington and Oregon know. it’s going to be very hard to get an exchange up and running in just a few months to be ready for Oct 1 open enrollment.  It’ll be worth watching – and if their successful, lead to questions about why things have been so much harder in the trailblazing states.

Finally, a bill to expand Medicaid was introduced yesterday by Republicans.  Why, in a state so opposed to Obamacare, would a bill like this get introduced by the Republicans?

“Republican Rep. Tom Loertscher of Bone, who voted against the exchange but introduced the Medicaid expansion bill, said it’s a necessary long-term solution to cover the escalating medical bills of Idaho’s indigent population. Loertscher says replacing the catastrophic health care program with Medicaid will save Idaho’s local property taxpayers $478 million over the next decade.”

Idaho has a unique locally-funded indigent health system that Medicaid expansion would replace.  If you’re looking at it from the direction of cost savings, Idaho stands to gain significantly from federal funding in this instance.