Editor’s note: The following was submitted to the Chronicle by Marge Arnzen and was written by Steve Ackerman for the GemStatePatriot website. 
1) STATE EXCHANGE ADMINISTERS FEDERAL RULES OVER BUYING AND SELLING INSURANCE:
Benefits offered; Coverage levels set; and Rating system that determines your premium are all under federal control.
Where is Idaho's control? Where is your control?
Did you know Idaho health plans sold through the State Exchange must be approved by the Department of Health & Human Services? What matters in a company is not who sits on the board, it is who controls the products the company makes and sells. Federal control will dictate the buying and selling of insurance on a state exchange.
Did you know things like the risk adjustments and other mechanisms insurance companies use to figure out your
premium are largely controlled by federal rules? Do you want a seat at the table built by the federal government? Do you think 25 other states said no to a state exchange because they thought they would lose a “seat at the table?”
2) STATE EXCHANGE WILL INVITE NEW FEDERAL TAXES UPON CITIZENS AND BUSINESSES OF IDAHO: New federal taxes only come with a state exchange. Law professors, public policy groups, the attorney general of Oklahoma and other states know this. Idaho’s insurance companies also know but don’t care about what it costs you (p. 12 of governor’s task force report).
Did you know the State of Oklahoma's lawsuit against the federal government is that the federal cannot apply the tax mandate on employers and individuals thru a federal exchange?
Did you know the governor said the only way to obtain tax subsidies was to purchase health plans thru the state
exchange? With tax subsidies and tax credits come tax mandates. Can you afford them?
3) STATE EXCHANGE BRINGS UNCERTAIN COSTS: 90 days after the governor's task force report was issued, the user fee for the state exchange more than doubled. The fee’s gone from $3 to $7 Per Member Per Month. What will you end up paying?
Did you know the scope of the 10 "essential health benefits" the federal government requires are not defined?
If you don’t know the scope of the work, you can’t price it.
Did you know Louisiana and Pennsylvania both said no to a state exchange because they couldn’t figure out the costs? Why do you think Idaho has a better handle on these costs?
Did you know the Idaho Farm Bureau came out against a state exchange? Idaho’s farmers understand rising costs; how about you?
4) STATE EXCHANGES WILL BECOME TARGETS FOR FEDERAL TAKEOVER: Federal rules require state exchange collect health and financial information on your enrollment activity, your claims activity, your adjusted gross income, your assets, your household size, your previous year’s tax status, and “other information” as “deemed appropriate” by HHS.
Did you know the state exchange will report its “marketing” and “customer satisfaction” performance to HHS?
Is Idaho a sovereign state or a Federal Government franchisee?
Did you know Senator Max Baucus and other senators sought to create a single federal exchange before agreeing to state exchanges that must follow one set of federal rules?
5) STATE EXCHANGE VIOLATES IDAHO LAW: Idaho's Healthcare Freedom Act says "Idaho ... exercises its sovereign power” when it comes to our citizens “choosing … health care services."
Did you know 14 states passed laws that make implementing the Affordable Care Act illegal? Idaho is
not alone in this fight. Let’s stand united against a bad federal program.
6) THE JANUARY 2014 DEADLINE IS NOT "SET IN STONE": The Department of Health & Human Services is not ready; the IRS is not ready; and Congress is not ready to act by January 2014.
Did you know many federal rules for a state or federal exchange are still not completed?
Do you remember the Secretary of HHS delayed the deadline for exchanges in November?
Do you believe with fiscal problems facing the federal government, there is money for a federal exchange?
The law has been around for almost three years, but no money has been allocated
for a federal exchange.
Did you know the only thing due on January 2014 is the tax mandate on businesses and individuals?
Enforcing the mandate is based on the law, and the law says mandate enforcement only applies to a state exchange. This will cost you real dollars.
Do you believe 25 other states would say no to a state exchange if they thought it would put their citizens and businesses in jeopardy?
I have been researching and opining on the State Health Exchange issue for some time now. I have delved into the policy and political aspects of this issue. Most people know the concerns I have with the idea of a State Health Exchange. But, when my good friend Wayne Hoffman of the Idaho Freedom Foundation discussed the problems with calling the State Health Exchange a “marketplace,” I decided to go through the process one would encounter if one was to purchase health insurance on the Exchange. Beyond that, I teach Economics and thus regularly discuss with my class the pros and cons of the free market versus a centrally planned approach, emphasizing the “real world” applications and impacts of their core principles. In other words, what they say versus what actually happens.
I go to the website yourhealthidaho.org and look for health insurance products. To my astonishment, I cannot find one health insurance product listed on the website. I go under the “What You Need to Know” tab, thinking I’ll find a set of products on display. Mind you, I’m not trying to figure out costs; I just want to see what health insurance products are sold through the State Health Exchange. To my amazement, there are no products listed. That’s strange because in a “marketplace” goods are normally on display. I then go the FAQs to see if they are there. I find many questions on who qualifies for what, descriptions of the different types of navigators, and, yes, the federal rules that govern the kinds of health insurance products that can be offered through the State Exchange – but, you guessed it, no products displayed.
When I call the 855-944-3246 telephone number, I speak to a “Consumer Connector.” She proceeds to
explain that the only way for me to see what products are offered is to apply. Now, my application is based mainly on financial information. You see, first one cannot find the actual products being “sold,” but then one must divulge financial information in order to complete an application. Only then, I assume, one can see the actual products. Even though the product is health insurance, what matters is your income, assets, and other financial information.
What is interesting about this is the fact that boat, car, life, and many other types of insurances do not require such financial disclosures. What do they care about? Whether you will pay for the product or not? A marketplace is a place for the open exchange of goods and services for other goods and services (or money).
The important word here is “open.” The last thing any retailer (or any other kind of seller) wants is to hide or obscure what they sell. And consumers expect to be able to see the products. With cars, you can take a test drive. With foods and drinks, you can taste them. With insurance, you can fit a policy to your needs before completing an application or giving out intrusive information. Only with the State Health Exchange must you divulge personal financial details about you and your family before you can see a product. For with the “state” health exchange, one must go to the federal Health & Human Services website to apply. Even when you go to that website, however, there is no listing of the insurance products. The only way to “see behind the curtain” is to apply first.
When you go to healthcare.gov, you have a listing of plans, but not for Idaho. Even though Idaho makes people enroll through healthcare.gov and even though Idaho’s health insurance plans must meet federal rules to be “legal,” one cannot find those health insurance products listed on the federal government website.
Calling and speaking to the HHS contractor (General Dynamics) is no help either. Again, if you don’t apply, then you cannot see the products.
What is almost funny is that the only industries I can think of that hide their products are drug dealing, arms smuggling, gambling, and prostitution. Those are the only kinds of “markets” where you must “sign up” prior to being allowed to see the product or service. We can now add to those infamous “markets” the State Health Exchange. As I’m sure my friend Wayne would agree, it is “Orwellian” to call this thing a “marketplace.” 
Thank you. 
Steve Ackerman

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