House Bill H0181a
2015 Freedom Index Score: (-8)
Analyst: Parrish Miller
Date of analysis: February 22, 2015 / March 23, 2015 (Amended)
ANALYST'S NOTE: As if House Bill 181 were not bad enough already at (-6), House Bill 181a, as amended
by the Senate, is even worse. The bill creates a "board of naturopathic physicians"; imposes licensure
requirements on individuals who "engage in the practice of naturopathic medicine"; defines and
restricts the scope of practice for naturopathic physicians; and imposes additional regulatory and
disciplinary measures on naturopathic physicians.
Point No. 1 — Does it create, expand, or enlarge any agency, board, program, function, or activity of
government? Conversely, does it eliminate or curtail the size or scope of government?
ANALYSIS: House Bill 181a creates Chapter 56, Title 54, Idaho Code, which shall be known as the
"naturopathic medical physicians licensing act." [Page 1, lines 10-14] Among other things, this
chapter establishes "in the department of self-governing agencies, bureau of occupational
licenses, the board of naturopathic physicians." [Page 3, lines 45-47]
The board shall consist of five (5) members appointed by the governor, two (2) of whom shall be
licensed pursuant to section 54-5608(1)(a), Idaho Code, one (1) of whom shall be licensed
pursuant to section 54-5608(2), Idaho Code, one (1) of whom shall be a physician licensed
pursuant to chapter 18, title 54, Idaho Code, and one (1) of whom shall be a pharmacist licensed
pursuant to chapter 17, title 54, Idaho Code. [Page 3, line 47 and Page 4, lines 1-5]
In other words, a board which has a majority of individuals licensed pursuant to the chapter on
it is charged with issuing licenses to and disciplining individuals who will be direct competitors to
the members of the board. (-1)
Point No. 3 — Does it give government any new, additional, or expanded power to prohibit, restrict, or
regulate activities in the free market? Conversely, does it eliminate or reduce government intervention in
the market?
ANALYSIS: In Section 54-5603, Idaho Code, House Bill 181a defines the "scope of practice" of
naturopathic physicians in ways which significantly constrain the activities of individuals offering
such services in the market. [Page 2, lines 32-48 and Page 3, lines 1-2]
For example, Section 54-5603(3), Idaho Code, says that "naturopathic physicians licensed under
this chapter may perform minor office procedures pursuant to privileges authorized by board
rule." [Emphasis added.] [Page 2, lines 43-45] In Section 54-5612, Idaho Code, we find further
limitations such as a prohibition against "performing minor office procedures using a laser
device." [Page 8, line 30] Considering that you can now perform minor procedures using a laser
device in your own home, it seems that such a prohibition is rather absurd. (-1)
ANALYSIS: In Sections 54-5602, 54-5613 and 54-5614, Idaho Code, House Bill 181a deals with
"natural health care services," the extremely narrow slice of activities still permitted outside of
the licensing structure set up by this chapter. The amended version of House Bill 181 is even
more restrictive in this regard. Included in the restrictions on these practices are the following
limitations:
(a) Does not use legend drugs or prescription drugs in such practice;
(b) Uses only natural elements including, without limitation, air, heat, water and light;
(c) Uses only class I or class II nonprescription, approved medical devices as defined in
section 513 of the federal food, drug and cosmetic act;
(d) Uses only vitamins, minerals, herbs, natural food products and their extracts, nutritional
supplements and homeopathic preparations and remedies not otherwise prohibited by
law; and
(e) Does not perform surgery or minor office procedures. [Emphasis added.]
[Page 2, lines 7-19]
Additionally, the bill contains the following demands in Sections 54-5613, Idaho Code:
"(1) Any person providing natural health care services who is not a naturopathic medical
physician or naturopathic physician and who is advertising or charging a fee for those services
shall, prior to providing such services, disclose to the client in a clearly worded statement:
(a) The practitioner's name, business address and telephone number;
(b) The nature of the natural health care services to be provided; and
(c) That the practitioner is not an "M.D.," "D.O.," "N.M.D.," "naturopathic medical
physician," "naturopathic doctor," "naturopathic physician," or "N.D." nor is the
practitioner licensed to provide these services.
(2) Before a practitioner provides natural health care services to a client for the first time, such
practitioner must obtain a written acknowledgment from the client stating that he has been
provided with the information described in this section and that he recognizes that the
practitioner is not licensed to practice medicine, surgery or naturopathic medicine or any
other type of medicine. The client shall be provided with a copy of this written acknowledgment
that must be maintained for two (2) years by the person providing the services. If the disclosure
information changes, then the practitioner has a duty to repeat the disclosure if a client obtains
services after the change." [Emphasis added.] [Page 9, lines 3-23]
This is blatant cronyism in which a small subset of service providers attempts to marginalize
their competition using the force of government. (-1)
ANALYSIS: House Bill 181a repeals Chapter 51, Title 54, Idaho Code, and declares that "all
licenses issued under Chapter 51, Title 54, Idaho Code, as repealed by Section 1 of this act, are
deemed to have expired for nonpayment of license fees and further are hereby declared to be
null and void." The newly created Section 54-5608(2)(a) does allow that "to be eligible for a
license to practice as a naturopathic physician in the state of Idaho, the applicant shall submit an
application, pay the fee and fulfill the following requirements ... have been issued a license by
the board of naturopathic medical examiners under chapter 51, title 54, Idaho Code, as it
existed at the time such licenses were issued and while the board had a contract with the
bureau of occupational licenses and such license was not revoked by the board of naturopathic
medical examiners." This subsection goes on to say that "any license issued by the board of
naturopathic medical examiners when it did not have a contract with the bureau of occupational
licenses shall not be recognized as a valid license." [Page 1, lines 4-9 and Page 6, lines 13-23]
This change has the potential to strip currently licensed individuals of their livelihood and to
disenfranchise both doctors and patients. Even for those currently licensed practitioners who do
qualify under this carve out, they will apparently still be required to pay the hefty fees of up to
$250 for application and up to $1,000 for this new licensure. (-1)
Point No. 4 — Does it increase barriers to entry into the market? Examples include occupational
licensure, the minimum wage, and restrictions on home businesses. Conversely, does it remove barriers
to entry into the market?
ANALYSIS: House Bill 181a mandates that "a license shall be required for a person to engage in
the practice of naturopathic medicine or naturopathic therapy." [Page 3, lines 31-33] (-1)
Point No. 5 — Does it directly or indirectly create or increase any taxes, fees, or other assessments?
Conversely, does it eliminate or reduce any taxes, fees, or other assessments?
ANALYSIS: House Bill 181a imposes three categories of fees on applicants for naturopathic
medical physician's licenses: an application fee of up to $250; a fee of up to $1,000 for an initial
license; and a fee of up to $1,000 for the annual renewal of a license. The bill also declares that
all of these fees shall be non-refundable. [Page 6, lines 46-47 and Page 7, lines 1-15] (-1)
Point No. 10 — Does it directly or indirectly create or increase penalties for victimless crimes or nonrestorative penalties for non-violent crimes? Conversely, does it eliminate or decrease penalties for
victimless crimes or non-restorative penalties for non-violent crimes?
ANALYSIS: In Section 54-5612, Idaho Code, House Bill 181a empowers the board of naturopathic
physicians to "refuse to issue or renew a license" or to "revoke, suspend or otherwise discipline
a license holder" for—among other things—"aiding or abetting a person, not duly licensed
under this chapter, in claiming to be a naturopathic medical physician or naturopathic physician
or in practicing naturopathic medicine or naturopathic therapy"; "violating any law or rule
pursuant to this chapter"; "having been convicted of any crime that reflects adversely on the
person's fitness to be licensed or registered pursuant this chapter"; or "failure to comply with a
board order." [Page 7, lines 22-24, 28-31 and Page 8, lines 3-5, 44] (-1)
ANALYSIS: In Section 54-5614, Idaho Code, House Bill 181a makes it a criminal offense to
"practice, attempt or offer to practice naturopathic medicine or naturopathic therapy as defined
in this chapter without having at the time of so doing, a valid, unexpired, unrevoked and
unsuspended license issued under this chapter." It is also made a criminal offense "to represent
one's self or assume or use the title or designation "doctor" or "physician" in association with
the practice of naturopathic medicine, or naturopathic therapy or the abbreviations "NMD" or
"ND" or any other title, designations, words, letters, abbreviations, sign, card or device to
indicate to the public that such person is licensed to practice naturopathic medicine or
naturopathic therapy pursuant to this chapter unless such person is so licensed under this
chapter." [Page 9, lines 28-38]
These prohibitions backed up with criminal sanctions are designed not only to limit the public at
large, but to box in those providing natural health care services and to prohibit them from
presenting and advertising themselves as a viable and competent alternative to the
naturopathic physicians who have campaigned for this law. (-1)