Gov. Butch Otter’s recommendation for a state-run health insurance exchange matches that of his working group that studied the issue for months – it’d be a privately operated, state-based exchange. Jon Hanian, Otter’s press secretary, said the privately run feature was a “better option” because it can get up and running more quickly than a traditional state agency. But, he said, “Let’s be honest. There was very little in these options that he liked. … But I think given all the work that the working group did and the fact that this decision kind of preserves some options and preserves flexibility for Idahoans, I think that’s why he came down where he did on this.” He added, “It’s going to be a work in progress.”

Health insurance exchanges, under the national health care reform law, will provide an online marketplace where consumers can shop for the plans, rates and features they want, and also access government subsidies if they qualify for them. States have the option of setting up their own exchanges, partnering with the federal government, or doing nothing and allowing the federal government to operate their state exchanges.

Said Otter, “All the criticisms of the exchange mandate that I and many others have expressed remain valid and troubling. The law is governed by an evolving set of increasingly complex rules and requirements. It is onerous, unwieldy and fraught with unknowns. That makes it all the more important to remember that my decision today can be rescinded if the Legislature disagrees or withdrawn by me if circumstances warrant – a real possibility on such a constantly moving target. But with what we know today, this is our best option.”

Otter will propose legislation when lawmakers convene in January to set up the new exchange. “We will have details about it in the State of the State,” Hanian said, the message the governor delivers to a joint session of the Legislature on its opening day, Jan. 7.

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