Published: Thu, February 15, 2018
People | By Leon Thompson

Ignoring the ACA, Idaho `freedom' plans come with limits

Ignoring the ACA, Idaho `freedom' plans come with limits

Blue Cross of Idaho submitted five health plans to Idaho insurance regulators on Tuesday that do not comply with the Affordable Care Act (ACA), according to local reports.

It is unclear whether the Department of Health and Human Services will step in and prevent Idaho from selling these plans.

The Trump administration is now monitoring the situation in Idaho, a Department of Health and Human Services (HHS) spokesperson told ThinkProgress in an email.

While Freedom Blues plans cover numerous "essential health benefits" required under the ACA, such as hospitalization, emergency care and mental health treatment, they do not include pediatric dental or vision coverage. Or will he allow state regulators to move forward, perhaps prompting other states to take more sweeping actions?

The move sets up a potential conflict with the federal government.

"There are rules and there's a rule of law that we need to enforce", Azar said at the hearing.

"Crazypants illegal", tweeted Nicholas Bagley, a law professor at the University of MI and former attorney with the civil division of the U.S. Department of Justice, who said that states can't pick and choose which parts of federal law to follow. After Idaho's announcement in January, ACA expert and University of MI law professor Nicholas Bagley called these plans "crazypants illegal".

"Both in terms of federal penalties and in terms of potential private lawsuits, they are taking on tremendous liabilities here", said Tim Jost, an emeritus professor at the Washington and Lee University School of Law who has been critical of efforts to unwind the law. "It's kind of jaw-dropping". Butch Otter's early January executive order that asked for "creative" options to expand choice on the exchanges.

If healthy people choose to buy Blue Cross of Idaho's cheaper plans - and why wouldn't they? - this will affect the rest of the marketplace, which suddenly has to cover a higher proportion of sick people. Under Blue Cross' similar state-based plan, the average family would pay $572 per month and have a deductible of $8,000.

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"The door is open for states to pursue our own reasonable solutions", Otter said.

Jeppesen says the ACA gives states regulatory authority "to make sure the market works and is stable", and the insurer is simply "following what the state has given us guidance" to do. If they are allowed to be sold, consumers will need to weigh the lower premiums against some of the coverage restrictions and variable premiums and deductibles, policy experts say.

"Those that are healthy and without subsidies have exited, and the best thing we can do is bring the healthy folks back into the pool", Jeppesen said.

Jeppesen says the insurer hopes to attract numerous "110,000 uninsured state residents who can not afford [ACA] coverage". "This isn't meant to undermine the ACA products, it's meant to stabilize".

Additionally, they cap total medical care coverage at $1 million annually.

While such policies were banned by the Affordable Care Act, Idaho plans to use the law as a backstop.

Blue Cross of Idaho said it will sell robust, Obamacare-compliant plans on the state's web-based exchange next year, yet it's also applying to offer five "Freedom Blue" plans this week off the exchange.

The plans would not have to cover all essential health benefits, which are 10 items of basic care areas any ACA plan must provide.

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