In Idaho, Gov. Butch Otter told his state insurance department to be bold and creative in designing health care coverage unfettered by the “overreaching, intrusive nature of Obamacare and its infringement on the freedoms of Idahoans.”
Six weeks later, companies were back with plans that do not include maternity care, charge older residents more than allowed under the Affordable Care Act, can enact yearly coverage limits and can refuse to insure some people because of previous conditions.
“In the nearly eight years of the ACA, this order by a lame-duck Republican governor is a singular act of audacity – the first time any state has stepped out on its own to foster a parallel insurance universe,” wrote Amy Goldstein in the Washington Post in a story headlined, “Idaho tests the bounds of skirting Affordable Care Act insurance rules.”
“As events move swiftly on the ground – with Blue Cross of Idaho announcing that it hopes to start selling alternative ‘Freedom Blue’ plans in March – the state’s maneuver has sparked a tempest that has spread to Washington. Dispute is raging over whether Idaho’s maneuver is legal and whether it is a clever balm for broken insurance markets or a slide back to shoddy, unfair insurance practices that the ACA had fixed.”
It is not clear what ACA “had fixed,” but it is clear the media has focused on whether this practice is legal. Otter, the governor, said Congress’ rescinding the individual mandate indicated that Congress was open to a variety of state-level reforms.
Mainstream media said otherwise.
“Otter’s executive order would allow health insurers to once again sell policies – and engage in practices – that were made unlawful by the ACA,” wrote Wendell Potter at the journalism non-profit tarbell.org. “Although many health care policy experts believe the order is in violation of federal law, the governor is counting on the Trump administration to look the other way.”
Idaho officials say they have been in contact with the Department of Health and Human Services throughout their process and are confident they are proceeding legally. Alex Azar, Secretary of Health and Human Services, has declined to comment on the case on the basis of not having enough information. But according to the Post, his department has been urging states to stretch the rules for months now.
“In its eagerness to undercut the law, the Trump administration has urged states for month to think of ways to alter their ACA marketplaces and Medicaid programs,” Goldstein wrote. “What makes Idaho so bold is that it didn’t even bother to ask.
“If the federal government lets Idaho continue along its path (note the emphasis on the supremacy of Washington in what always has been a state matter), ACA fans and foes alike predict that other states also will defect from the law’s insurance rules.”
“It could be the tip of the spear,” the Post quotes Trish Riley of the National Academy of State Health Policy as saying.
Later, it tells us “consumer advocacy groups are crying foul.” Some obviously are enjoying the choice and lower premiums, but never mind.
“If this ends up peeling healthy people out of the exchange because they can get a better price elsewhere and can afford to gamble on a skimpier plan, who is left in the exchange?” the spokesperson for Idaho Voices for Children asked.
If healthy people leave the exchanges for better prices, that’s not nor should be a concern of the state. The idea is to bring down the cost and up the value of health care.