Trump Administration: Idaho Can’t Violate Key Obamacare Provisions

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Trump Administration: Idaho Can’t Violate Key Obamacare Provisions

Nicole Knight

Blue Cross announced in February that it would sell insurance plans in Idaho that ignored some ACA requirements—a move a top U.S. Senate Democrat had called "illegal."

A Trump administration official on Thursday quashed plans by Idaho officials to sell health insurance that violates the Affordable Care Act (ACA) in a decision that was watched by state-level leaders across the United States.

In a letter to the state’s governor, Seema Verma, administrator of the federal Centers for Medicare and Medicaid Services, rejected Idaho’s proposal to sell state-based plans that lack ACA provisions, writing “we have a duty to enforce and uphold the law.” But Verma struck a conciliatory tone with Gov. C.L. “Butch” Otter (R), suggesting the state could make a few modifications to legally offer short-term insurance plans.

Otter launched Idaho’s experiment against the ACA, or Obamacare, with an executive order in January, after some insurance premiums in the state soared by up to about 50 percent. Last month, Blue Cross announced it would sell insurance plans that ignored some ACA requirements in the state—a move a top U.S. Senate democrat had called “illegal.” But the question, until Thursday, was whether the federal administration, which had acted to undermine the ACA, would uphold the law.

In blocking the Idaho insurance plans, Verma warned that violators could face civil fines of up to $100 per day per enrollee.

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The state-based plans differ from ACA plans in several ways, charging older people significantly more than younger ones, hiking premiums on sick people up to 50 percent, and capping annual coverage at $1 million, as Kaiser Health News reported. But similar to the ACA, the plans would require insurers to cover many people with pre-existing conditions and provide most ACA benefits, such as prescriptions, preventive care, outpatient services, emergency care, hospitalization, mental health and substance abuse treatment, rehabilitation, and lab services, as Kaiser Health News reported. And at least one state-based plan would be required to provide maternity coverage.

Idaho Department of Insurance Director Dean Cameron on Thursday told the Idaho Statesman his office had expected the denial. He said the short-term plans the administration favors would be worse for Idahoans than the coverage Blue Cross had wanted to offer.

Blue Cross officials said they were still reviewing the letter.