BOISE -- An Idaho state health exchange, it's a place where some people and businesses could shop for their private insurance plans under the Affordable Care Act. But Idaho doesn't have one, or has a plan to create one yet.

Idaho Governor Butch Otter has a big decision on his hands. Will he create a health exchange for Idaho? Will he go past the November 16th deadline, and allow the federal government to create one for the state? Or, will he just wait for Congress and possibly, a new president to possibly repeal the Affordable Care Act?

According to Governor Otter's spokesman, all those options are on the table right now, and no decision has been made. Although, he did say he won't call lawmakers back for an emergency session.

Last legislative session, the state refused $20 million in federal money to help set up a health exchange.

This week, Idaho Congressman Raul Labrador, along with many others in the House and Senate sent a letter to all 50 Governors, urging them to refuse to create an exchange, thereby helping their repeal efforts in Congress. Labrador believes a repeal is likely.

But he also says since state exchanges have to comply with the same regulations as the federally-run exchange it's a waste of time and money to set one up, which would result in higher premiums.

But, Idaho House Minority Leader John Rusche (R-Lewiston), a retired doctor and former insurance company employee, says it's past time Idaho created its own exchange. We certainly have lost time. We've lost half-a-year.

Rusche says it would give the state more control, compared to the federally-run exchange. If you're a small state like Idaho, you won't have much say on how it's run on policies... All that's going to be done out of Bethesda, instead of out of Boise.

He also believes a state-run exchange would lower premiums, since the prices on the federal exchange would be based on national markets involving states with higher costs.

They need to step up, and get the ball moving, said Rusche. It is a Constitutionally-valid federal law. I think it's unwise to just kind of hope it goes away.

We hope to hear more from the Governor next week about a possible exchange.

Meanwhile, Representative Rusche, along with other Republican and Democratic lawmakers will meet July 30th to discuss their options in the wake of the Supreme Court upholding the president's health care overhaul.

At that same meeting, lawmakers will discuss whether Idaho should expand Medicaid eligibility rules, a part of the act that the justices ruled was optional.

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