Election Central

Otter punches back: So you want Planned Parenthood helping sell health insurance?

UPDATED, 2:15 p.m. with Fulcher response defending his pro-life credentials.

Gov. Butch Otter responded aggressively to challenger Russ Fulcher’s continued hammering of Otter for creating the state-run health insurance exchange, Your Health Idaho.

Otter says Fulcher, R-Meridian, the Idaho Senate’s majority caucus chairman, “favors allowing the Obama administration to impose a federal insurance exchange in Idaho.” That, Otter says, would open the door to outfits like Planned Parenthood helping customers decide on health insurance policies.

Pro-choice Planned Parenthood, of course, is particularly unpopular among tea party conservatives Fulcher counts on to help him defeat Otter in the May 20 Republican primary. Opposition to the exchange is Fulcher’s top issue.

Otter’s retort comes in response to a 975-word email Fulcher sent to supporters Wednesday, offering his latest critique of Otter’s state-run health insurance exchange. Otter’s decision, made in concert with the 2013 Legislature, makes Idaho one of three states with GOP governors to operate its own exchange under the Affordable Care Act. The other 26 GOP governors, including Utah Gov. Gary Herbert, have deferred to federally-operated exchanges.

“Idaho should not spend another man-hour or taxpayer dime propping up this job-killing program,” Fulcher said Wednesday of the website and call center operated by the state.

Otter’s reply came in a statement provided by his campaign:

“With Russ’s continuing opposition to the state exchange it has become abundantly clear that he favors allowing the Obama administration to impose a federal insurance exchange in Idaho,” Otter said.

“I do not believe abdicating to the Obama administration is in the best interests of Idahoans.  You need to look no further than our conservative neighbors to the south, Utah, who now have a federal exchange that is spending hundreds of thousands of dollars to allow Planned Parenthood to serve as navigators on their exchange. I do not think this path is in the best interest of our citizens and I remain committed to protecting their health care decisions to the best of my ability.”

In reply to Otter’s statement, Fulcher had this to say Thursday:

“When Gov. Otter acquiesced to the Obamacare health exchange, he also acquiesced to the federal mandate that abortion inducing drugs be covered in all qualifying health care plans. This is revolting to the pro-life community of which I am a part – and one of the major reasons I stand WITH the pro life community and the majority of GOP Governors in opposition to Obamacare. To imply I’m somehow supportive of Planned Parenthood is misleading, and an attempt to distract attention away from the fact that it was Governor Otter that voluntarily embraced Obamacare.”

Fulcher’s Wednesday email to supporters also includes links to campaign videos, one replying to
Otter’s State of the State Address and one highlighting his 2013 Senate vote against the state-run exchange.

Fulcher’s email follows:

Why I Disagree with Governor Otter’s Letter on the Idaho State Exchange


On December 23, just before Christmas, Governor Otter sent a letter explaining all the reasons he supports a state run, federal insurance exchange claiming it is “state-based”. I disagree.

Butch Otter continues to defend his choice to partner with Democrat governors and Barack Obama by claiming we have a “Made in Idaho” health exchange.

The reality is that this state-run, federal exchange receives all its money from the federal government.  It can only sell policies that meet federal rules. It charges people a percent of the premium — just like other federal exchanges. People sign up through federal software — healthcare.gov.  It must collect personal financial and health information on Idahoans per federal rules.  To get federal tax subsidies, people must buy a health plan on the state-run, federal exchange.  Even the recent enrollment extension for Idahoans came from the federal government.

When it comes to marketing and advertising, it must meet federal requirements.  Soon Idahoans will be getting calls on whether they like these federally mandated policies, as the state run, federal exchange must share its “customer satisfaction data” and product quality and pricing with the federal government.

We need an alternative system in place that will empower Idahoans with a patient-centered approach.  We must create competition and choice to help lower prices.  We must incentivize people by letting them pick and manage the types of policies they need for themselves and their families, instead of one size fits all mandates.  We must bring more providers into the picture, giving them a true stake in the process and the outcome.  We need an open, diverse, and competitive market for healthcare and healthcare insurance.

Healthcare should be accessible, affordable, and of high quality.  Everyone agrees we need to make sure the most vulnerable among us do not slip through the cracks. While our state run, federal exchange props up Obamacare, 105,000 Idahoans have lost their insurance.

Obamacare was created to get insurance to those without. We have no proof through Idaho’s state run, federal Obamacare exchange that we are accomplishing that goal.  The exchange claims 20,000 signed up, but the state can’t tell us if that includes anyone who had their policy cancelled or did not previously have insurance.  We don’t know how many Idahoans actually have insurance protection.  We only know how many Idahoans are losing their health security through the state run, federal exchange.

Idaho should not spend another man-hour or taxpayer dime propping up this job-killing program.

My Point-by-Point Rebuttal to Governor Otter:
(Otter’s claims in bold type)
1) “The federal government did not review or regulate plans sold on the exchange:”

Every plan sold through an exchange must be a “Qualified Health Plan” under section 1301 of the Affordable Care Act (ACA).  Things like the 10 “Essential Health Benefits.”  This is why plans got cancelled; they did not meet rules like that one.  That’s why Gov. Otter went to Secretary Kathleen Sebelius (In Wash. DC) and not Idaho Director of Insurance, Bill Deal.  Gov. Otter asked for a delay on imposing these federal rules.  It’s also why President Obama put in a delay. If we follow federal rules, we are under federal rules.

2) “Federal government did not determine which insurance companies would be allowed to sell products … :”

Determining which company can sell insurance in a state is not the focus of the ACA – that is a red herring.  But, every company that sells health plans must meet federal rules when it comes to the benefits offered, the coverage provided, and the risk rating system that helps determine the premium a person pays.

3) “Federal government will not assign our state a federal call center … :”

While a person deals with an Idaho-employed “Consumer Connector”  when they apply, they then get routed to a federally-contracted call center.  Why?  Because the person must sign up through healthcare.gov — the federal software.

4) “Federal government will not govern our marketplace … :”

This is only half-true: Board configuration, bylaws, etc. are done by Idaho.  But here is the problem: Many of operational components are required by the federal government: Website, data collection of personal financial and health information; even having to have a toll-free number.  It is spelled out in the law.  Idaho gets marketing money for advertising from the federal government.  Idaho must share its marketing strategy and materials with the Department of Health and Human Services (HHS) in Wash. DC.  And, the federal government requires product quality and price ratings, buyer satisfaction surveys, etc.  It is all coming.

5) “We control assessment fees:”

This is disappointing because it is dishonest.  Idahoans were told the user fee would be a “fixed dollar amount.”  Staffers from Gov. Otter’s office communicated that: Tammy Perkins, David Hensley, and maybe others.  Idahoans were told the “state exchange” is better because we’re charging a “fixed dollar amount,” while the feds charge a percent of the premium — wherever that premium ends up.  Now, we’re charging a percent of the premium — wherever that ends up.  This is why Rep. Vander Woude, Senator Durst, and others wanted a cap on that “fixed dollar amount.

Today, there is no limit on what is charged: If premiums go up, it is a percent on a bigger number.  And, the exchange is talking about increasing the percent to 2.6% of the premium — wherever that premium ends up. They have to because they must be self-sufficient by 2015, i.e., no more federal grants.  That’s also under the federal rules.

On the campaign front, I would like to share with you two videos the Fulcher for Governor team has released so far.

The first is my response to Governor Otter’s State of the State speech. The second highlights my decision to stand with a handful of brave Idaho leaders and say “NO!” to Governor Otter’s decision to set up an Idaho state exchange.


Dan Popkey came to Idaho in 1984 to work as a police reporter. Since 1987, he has covered politics and has reported on 25 sessions of the Legislature. Dan has a bachelor's in political science from Santa Clara University and a master's in journalism from Columbia University. He was a Congressional Fellow of the American Political Science Association and a Journalism Fellow at the University of Michigan. A former page in the U.S. House of Representatives, he graduated Capitol Page High School in 1976. In 2007, he led the Statesman’s coverage of the Sen. Larry Craig sex scandal, which was one of three Pulitzer Prize finalists in breaking news. In 2003, he won the Ted M. Natt First Amendment award from the Pacific Northwest Newspaper Association for coverage of University Place, the University of Idaho’s troubled real estate development in Boise. Dan helped start the community reading project "Big Read." He has two children in college and lives on the Boise Bench with an old gray cat.

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Posted in Election Central, Idaho Politics