Saturday, 21 April, 2018

CMS tells Idaho it must comply with the Affordable Care Act

Otto Kitsinger  AP Otto Kitsinger AP
Melissa Porter | 10 March, 2018, 14:41

CMS Administrator Seema Verma wrote in a letter (PDF) to Idaho Gov. C. L.

Health policy experts were closely watching the Idaho situation because it could have opened the door for other states to flaunt the rules of Obamacare.

The average premium for these "freedom" plans would be 25 to 50 percent lower than the insurer's Obamacare plans, according to this great breakdown from Katie Keith at Health Affairs.

Blue Cross of Idaho submitted plans that impose annual limits on claims and would charge sicker enrollees more, in some cases - two things barred by the Affordable Care Act.

Blue Cross of Idaho announced last month it would seek to sell five plans that sidestep the ACA.

Verma said that while Idaho's desire to bring down costs - the stated reason for the policy - was admirable, it was also illegal.

In the interim, Blue Cross of Idaho announced that it would gladly sell bad insurance plans to the good people of the Gem State - and other conservative states began seeing the virtues of simply pretending that Obamacare no longer existed. "Butch" Otter and Idaho Department of Insurance Director Dean Cameron on Thursday, reminding officials that the Patient Protection and Affordable Care Act remains the law and that CMS has a duty to enforce that law. This arrangement would allow (temporarily) healthy people to get (junky) insurance at a very cheap price - while rendering the risk pool for Obamacare-compliant plans exceptionally sickly, thereby causing premiums to skyrocket for people who required comprehensive coverage.

In the event that a state does not enforce the ACA, the HHS is technically obligated to step in and enforce the law.

The Trump administration on Thursday blocked efforts by Idaho lawmakers to circumvent certain aspects of the Affordable Care Act (ACA), The New York Times reported.

If Idaho was allowed to move ahead it could have opened the door for other conservative states to flout the law but, for now, that opening appears to have been shut.

"We are grateful that the Trump Administration is working with states to roll back Obamacare's regulations and we look forward to an ongoing discussion that will result in implementing our state-centered solutions for healthcare". 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. "Make no mistake, however, while this is the right decision, the administration continues its many efforts to undermine the law and chip away at its protections, including by encouraging Idaho to sell junk plans in another way".