June 27, 2011
- John Bechtel
- Tom Dale
- Tammy de Weerd
- John Evans
- David Ferdinand
- Brad Holton
- Vicki Thurber
- Dave Bieter
- Vern Bisterfeldt
- Scott Dowdy
- George Hyer
- Nate Mitchell
- Garret Nancolas
- Craig Telford
Staff and Guests
- Bryan Ricker – Senator Crapo’s Office
- Dennis Warren – Blue Cross of Idaho
- Bill Larsen
Tom Dale opened the meeting and welcomed everyone to Nampa. The City of Nampa is in the midst of their budgeting process. The have had an electric franchise fee for a couple of years and this money is dedicated toward capital improvements. The State has known for numerous years that they are falling behind on capital investments, specifically roads. In the City of Nampa, there are a lot of things about roads that are out of their control, specifically the gas tax. The Public Works Director, Michael Fuss has undertaken an in-depth look at capital needs for all of their public works facilities. Their payment management plan for roads indicates they need to spend at least $5 million to just keep up with maintenance. They are spending $1 million which means they are falling behind $4 million a year. They have no opportunity to raise this additional revenue.
They also have a public facility ordinance. For a City like Nampa they have 4-5 Fiber Optic Companies that are racing to put Fiber in their right-of-ways. Every time they put Fiber in the ground it affects them. Every time they go to do a water or sewer repair, they don’t know where the Fiber is.
There is a provision in State law that says private, for profit businesses are not allowed to use public facilities without paying the public entity for the use of that facility. He maintains their streets and rights-of-way are a public facility. Their attorney has been busy drafting an ordinance that will enable the city to charge a fee for the use of the right-of-way. This money is all going to be dedicated to the street fund.
The electric franchise fee is currently being used for downtown revitalization and capital needs. There is no extra money for these capital needs and they only become more expensive the more you delay them.
Health Care Reform
Tom introduced Dennis Warren – VP of Account Management for Blue Cross of Idaho. He mentioned that Bill had contacted their Director of Governmental Affairs and she had put the request out within the Company for someone to come speak to the Partnership on this issue. He volunteered partly because he is from the area. He was born in Caldwell, grew up in Greenleaf, works in Meridian and lives in Garden City.
As a result of health care reform, there has been a real expansion in preventive care. Blue Cross of Idaho is offering preventive care benefits at no cost including no coinsurance or deductible for preventive care services when using in-network providers.
John Evans asked if there is a Plan B in case health care reform isn’t funded, if everyone is granted a waiver….depending on what happens in the next couple years. Dennis said the act was really health insurance reform. The transformation of the system all depends on whether the individual mandate survives the challenges with regard to whether they are constitutional or not. From their standpoint, they have to plan as though the act goes through as written.
It has been apparent that the portability portion of the act is going to become more and more critical as we move towards 2014. By 2014, health insurance exchanges have to be up and running. Director Diehl has been active in insuring that there is an Idaho Insurance Exchange available. The Insurance Exchange will insure that small groups will be able to access the subsidies and financial components of the law. If they don’t have the exchange up and running by 2014, the Federal government will have a system in place that will be available for Idaho to participate.
If you look at just the wellness components, they have added four new vaccines including Hepatitis A, HPV Meningococcal and Shingles. For all children and their regular immunizations there will be added cost of an average of approximately $58.
John Bechtel said that we are coming to a point where the cost of health insurance is going to be more than employee’s wages. This is not a good picture. Dennis indicted that costs are the real reason for the drive for reform. The reason the exchanges in 2014 are a very important vehicle is this will be where employees earning up to 400% of the poverty level will be able to go to purchase coverage and access the subsidies that are in the legislation.
The Meridian School District did a study and assuming nothing changes between now and 2017, 85% of their employees would qualify for some subsidy. If your employees are making less than $88,000/year for a family of four, they would be eligible for a subsidy if they went to the exchange.
There have been studies that have indicated by 2019 up to 30% of employers will no longer opt to carry health insurance for their employees. The benefits coming out of the exchange will be similar to those you see with Medicare.
Tom Dale stated that they provide full coverage for their employees with a small contribution from the employee. If people are under the 400% of poverty level, can go to the exchange and get a better deal? Dennis stated, for employers of more than 100 people, if the law stays as it is, in 2017 your employees that make less than the 400% would be eligible for a subsidy from the exchange. The maximum premium at that rate for a family of four would be $700 per month. This would be a dramatic drop in costs for that family of four depending on the benefit package they have. The employer is going to have to make a decision. Do I continue to pay retail or do I let my employees go to the exchange. This could change the landscape dramatically.
David Ferdinand indicated that the State has a catastrophic fund for indigent care. Counties used to do all this. Counties now pay $11,000 per claim. Every two weeks, they hear approximately 150 cases that come before the county for indigent care. The changes that are being made are far reaching. Governments are responsible for this exchange and someone has to pay for it somehow.
Dennis stated that ultimately in 2017, the need for the County funds will disappear. However someone has to pay for it one way or another.
David stated he was recently in a White House meeting where it was stated they want to take everything that is supposed to happen in 2017 and put it into 2012.
Dennis did say that the rules have not been written yet on what coverage’s and essential benefits will look like once the Act goes into place.
John Evans asked what the role of competition might play in the reduction of health care costs. The presumption is you can buy health care insurance like you can buy auto insurance and by shopping you could obtain a reduction in cost. The implication is that the insurance providers that are allowed to provide health care insurance in Idaho overcharge.
Dennis stated that the way the law tried to get at this perception is the medical loss ratio information included in the packets. As an enterprise that is writing group (100+) health care insurance, at a minimum have to be paying out 0.85 cents on a dollar toward benefits and 15 percent cant be used for administration. If they don’t, they are supposed to refund that money that is gained in 2011. For individual policies, the ration is 80-20.
A lot of the health insurance reform provisions, regardless with happens with benefits and costs of benefits; the guaranteed issue, the leveling of the playing fields, making sure administrative costs are in-line, are components that are likely to remain. They will make it so it is a low margin business at the end of the day. Most of the national players in the insurance field are for profit businesses. In Idaho, the Blue’s are not-for-profit organizations.
Tom Dale asked if these provisions would potentially put some insurance providers out of business. Dennis indicated absolutely. Additionally, as it continues you will see some new players come into the markets that aren’t insurance companies currently. There is speculation that Wall-Mart is well positioned to enter the insurance market. If you are in an exchange environment, it is more of a commodity and the nature of the competition could be entirely different than what we see in the market currently.
Dennis stated that Idaho will be ripe for tele-medicine. We have an undersupply of primary care physicians and the distances make it difficult to obtain care. So he believes, even thought they have been resistant to, they will be reimbursing for phone and Skype type medical consultation.
Deer Flat Wildlife Refuge
Tom introduced Bryon Ricker with Senator Crapo’s office. Bryon indicated that right now, there are several groups that have come out on this issue. They have been active at getting people involved during the public comment section.
Senator Crapo, at the request of Commissioner Ferdinand got involved almost four years ago. Fish and Wildlife is doing their Comprehensive Conservation Plan. This is a management plan on how they are going to run the refuge. Under the 1997 law they are required to take into account six priorities (wildlife observation, photography, and education, environmental observations, fishing and hunting). Anything outside of these priorities needs to be justified.
The Deer Flat Wildlife Refuge has just released their alternatives. Their preferred alternative (number three) restricts boating to one part of the lake. Currently boars are allowed throughout the lake.
Under their process, they are not required to take into account economic or cultural impacts that happen as a result of their decisions. The decision will have a large economic impact to Canyon County. It will also have economic impacts on Ada County. Because you will see boaters leave Canyon County to go to Lucky Peak which is already overcrowded by a lot of accounts. Under their plan they do not have to take these impacts into consideration.
Alternative number one is a status quo alternative leaving access and use on the refuge as it is. Fish and Wildlife has told Bryan flat-out that they are required by law to give a status quo alternative. However, they will not do this alternative despite the public comment.
Bryan indicated that Fish and Wildlife will tell you it is not a vote. No matter if there are 10,000 comments in favor of the status-quo and 50 people favor alternative number three, they will go with alternative number three. Ultimately, regardless of the public comment, Fish and Wildlife has the ability to make the decision itself. The public comment period is a means of letting the public think they have a say.
They are working to get people involved. On their end, they have had some talks with the upper management of the Refuge system. As a delegation, there are legislative options ready to go. If Fish and Wildlife does not listen to the public, the County or other stake holders, they may look at drafting legislation to removing Fish and Wildlife as the agency in charge of the Deer Flat Refuge and put it back in the hands of the Bureau of Reclamation who would contract with Idaho Fish and Game to manage the wildlife aspects. It is understood that Idaho Fish and Game is completely fine with the mix of recreation at the refuge now.
John Evans asked which agency is charged with enforcement. Bryan stated that Fish and Wildlife relies on the County Sheriff to provide the marine enforcement.
Bryon pointed to a study in the National Refuge Update which indicates, for every $1.00 appropriated to the Refuge system by Congress, they returned $4.00 back to the economy locally. He added that 84% of this is non consumptive use. This is beach and water use, meaning because of the refuge, people are buying boats, gas, food, etc. So everything they say they are putting back into the economy is the very thing they are trying to restrict.
Currently, in the preferred alternative in the Deer Flat Wildlife Refuge, they would not allow dog walking or horse back riding.
David Ferdinand indicated that the Manager at Deer Flat has quite a history of shutting boating and other recreation down in two previous Refuges’ she has managed. Brad Holton added that in those two previous refuges, the difference is that they were not irrigation facilities and this one is.
Bryan indicated they are watching the public comment real closely. Depending on the end results, they have several strategies to move forward to get Fish and Wildlife to listen to the public comment that is made. He added, in the end, recreation will continue as it has. The facility is an irrigation facility first and foremost. The Refuge is a secondary priority to this.
Bill proposed that the Partnership write two letters. The first letter would address the management alternatives and lend support for alternative number one which is status quo. The second letter would mirror the letter written by the Canyon County officials to the Idaho Congressional Delegation.
Tammy moved that the Partnership send two letters. One letter should be sent to the public comment process regarding maintaining status quo. The second letter would be sent to the Congressional delegation mirroring the sentiment of the Canyon County letter. Brad seconded. The motion carried unanimously.
Executive Directors Report
Bill stated that Tom, John and he went to Owyhee County Commission and delivered a presentation to them about the Treasure Valley Partnership. He indicated that they seemed to be receptive to maintaining membership. However they did have a concern with regard to the fact that the Partnership meetings conflict with their Commission meeting dates on Mondays. He developed a proposed meeting schedule for next year that would provide an alternate Monday/Wednesday schedule. He added that on the Wednesday meetings, he tried to make them happen in Canyon County for convenience of travel from Owyhee County.
Bill indicated that Ada County run up to a conflict with hosting the August meeting. After talking with Owyhee County, he proposes moving the August meeting to the 17th and have Owyhee County host the meeting.
Bill stated that he had worked with the Ashley Inn in Cascade for the retreat since our meeting there last year. He followed up with them a couple times over the winter and all appeared ok. He called up to get details organized in the last month and found out that their meeting scheduling person had changed and our dates were somehow misplaced and the new person had schedule on top of our proposed date for the Retreat. He suggested the Terrace Lakes Resort for this year’s Retreat. David Ferdinand indicated that even though Tamarack Lodge is hurting they are offering good deals. Bill stated he would contact them and see what they might have available.
Brad Holton stated he had recently signed a contract a pubic works contract for $4.7 million for a treatment facility. They are coming in under the super clean water act and will be 150 times cleaner than Boise.
John Bechtel moved and David Ferdinand seconded the approval of the minutes and financial report.