Feb 14, 2018

Idaho insurer unveils plans that don't comply with the ACA

HHS secretary Alex Azar. Photo: Win McNamee/Getty Images

Blue Cross of Idaho is taking up the state’s controversial offer to sell insurance plans that don’t comply with the Affordable Care Act — a move many legal experts believe is illegal, and which policy experts say will undermine the ACA.

What’s next: It’s not clear whether the Trump administration will step in to enforce the ACA’s requirements. If it doesn’t, more conservative states will likely follow Idaho’s lead, effectively rolling back some of the ACA’s most substantial consumer protections and coverage mandates.

Driving the news: Idaho Gov. Butch Otter previously said the state would allow the sale of insurance plans that don’t comply with all of the ACA, and Blue Cross of Idaho announced today that it would start selling some of those plans next year.

The details, according to plan documents provided by Blue Cross and a report in the Idaho Statesman:

  • These new plans will ask consumers about their medical histories and charge them higher premiums if they have pre-existing conditions. That’s illegal under the ACA.
  • The policies will cap their total coverage for each customer at $1 million per year. The ACA banned annual caps.
  • Some out-of-pocket costs, like co-pays for certain services, would be lower in the new plans than in the company’s ACA-compliant policies. But consumers would be on the hook for more out-of-pocket spending overall.
  • Consumers could not apply the ACA’s premium subsidies to these new policies.

Why it matters: This is the most aggressive effort any state has made to circumvent the ACA. If these policies do come to market next year, they’ll likely siphon off healthier customers who don’t use much health care — which in turn would leave a sicker, more expensive customer base in the market for ACA-compliant coverage, causing those plans’ premiums to rise.

  • If neither the Trump administration nor the courts intervene to block these policies, this could be a roadmap for other red states to create their own parallel insurance markets.

The odds: Health and Human Services secretary Alex Azar told a House committee today that Idaho hasn’t asked for a specific waiver from the ACA, and did not explicitly say how his department would approach Idaho’s experiment.

  • “There is a rule of law that we need to enforce,” Azar said.

Go deeper

MLB's Rob Manfred is latest villain in Astros' cheating scandal

Illustration: Aïda Amer/Axios

MLB Commissioner Rob Manfred's decision to grant Astros players immunity in exchange for confessions about their sign-stealing scheme has undermined his reputation — and he only made himself look worse on Sunday.

The interview: In a 45-minute conversation with ESPN, Manfred asserted that public shame was punishment enough for the Astros. He also called the World Series trophy "just a piece of metal" and said that taking a title away from Houston "seems like a futile act."

Go deeperArrow51 mins ago - Sports

Economists warn coronavirus risk far worse than realized

Photo: Anthony Wallace/AFP via Getty Images

Worries are growing that the economic impact from the novel coronavirus outbreak will be worse than expected and that markets are being too complacent in factoring it in as a risk.

What's happening: The number of confirmed cases has already far outpaced expectations and even those reports are being viewed through a lens of suspicion that the Chinese government is underreporting the figures.

National newspapers thrive while local outlets struggle to survive

Illustration: Sarah Grillo/Axios

While big national newspapers grow stronger, local newspaper chains that have for decades kept the vast majority of the country informed are combusting.

Why it matters: The inequity between giants like the New York Times and the Wall Street Journal and their local counterparts represents a growing problem in America as local communities no longer have the power to set the agenda for the news that most affects them.