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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

10 mins ago - World

NYT: Biden won't immediately remove U.S. tariffs on China

President-elect Joe Biden during an event in Wilmington, Delaware, on Tuesday. Photo: Alex Wong/Getty Images

President Trump's 25% tariffs imposed on China under the phase one trade deal will remain in place at the start of the new administration, President-elect Biden said in an interview with the New York Times published early Wednesday.

Details: "I'm not going to make any immediate moves, and the same applies to the tariffs," Biden said. He plans to conduct a full review of the current U.S. policy on China and speak with key allies in Asia and Europe to "develop a coherent strategy," he said.

Trump threatens to veto Defense spending bill over social media shield

Photo: Erin Schaff - Pool/Getty Images

President Trump tweeted Tuesday a threat to veto a must-pass end-of-year $740 billion bill defense-spending authorization bill unless Congress repeals a federal law that protects social media sites from legal liability.

Why it matters: Trump's attempt to get Congress to end the tech industry protections under Section 230 of the Communications Decency Act is the latest escalation in his war on tech giants over what he and some other Republicans perceive as bias against conservatives.

The walls close in on Trump

Photo: Tasos Katopodis/Getty Images

With Bill Barr's "Et tu, Brute!" interview with AP, President Trump is watching the walls close in on his claims of fraud, hoaxes and conspiracies.

Why it matters: Trump and his legal team continue to claim election fraud. But the Republican governors of Arizona and Georgia have certified their elections, a loyalist like Barr has weighed in, and lower-ranking officials have taken potshots.