Idaho Gov. Butch Otter and Lt. Gov. Brad Little have hit the road to promote their executive order asking Idaho insurers to offer cheaper plans that don’t comply with all requirements of the Affordable Care Act, making stops Monday in Lewiston and Coeur d’Alene.
The two will bring the same message to a “Capital for a Day” event in Genesee north-central Idaho on Tuesday.
“We’re trying to get people to understand that the executive order actually goes to those people that have been priced out of the market,” Otter said Monday from Coeur d’Alene.
“The no-action alternative is terrible,” Little added. “We had to do something. … We had to say, ‘How do we make this to where people have affordable insurance?’”
The proposal has brought Idaho a wave of national attention, most of it negative – with many experts saying the move is legally dubious. But state Insurance Director Dean Cameron said, “We don’t think that’s true at all. … We are confident that we are within our legal authority to do what we’re doing.”
Last week, Cameron’s department issued guidelines for the new “state-based” insurance plans. All seven categories of required minimum benefits stayed in, from preventive care to hospitalization, as did requirements to cover dependents up to age 26 on their parents’ plans. But the guidelines allow higher out-of-pocket maximums; exclusion of pre-existing conditions for those who haven’t had continuous coverage for 63 days prior to enrolling; broader age-rating differences; and other changes that Cameron said are likely to result in much lower rates, including the ability for insurers to offer lower rates to healthier customers.
Any insurer offering one of the new state-based plans, Cameron said, would still be required to offer ACA-compliant plans as well. “They’re required to be part of the same risk pool,” he said. “We see these plans as attracting the healthy back into that risk pool, which helps mitigate costs that the unhealthy are incurring. We think in the long run, it will be better for all Idaho citizens.”
Anyone with a pre-existing condition or age-rating concerns would likely opt for the ACA-compliant option, Cameron said, as would anyone who would qualify for a subsidy on the state insurance exchange.
Little said, “This is a way to pick up that 70,000 to 100,000 people that just keep dropping out of our pool.”
Cameron said he had a conference call with federal regulators, and then submitted the guidelines as soon as they were complete last week. He hasn’t yet heard back. “I guess I would anticipate that they may have some additional questions, and we stand ready to answer those,” he said.
Otter said Little took the lead on helping develop the plan when Otter was out for repeated back surgeries last summer, and has stayed in the loop ever since. “He was part of the all the discussions we had with the carriers … and I was not,” Otter said. “And that’s why it was important for me to include Brad on this information tour.”
Little also is running for governor; Otter has endorsed him.
Last week, a day after Cameron’s office issued the guidelines, Blue Cross of Idaho, the state’s largest insurance carrier on the state exchange, issued this statement from its president and CEO, Charlene Maher: “While we are currently reviewing the guidance, we believe the direction will provide uninsured middle-class families in Idaho with choices in health insurance at a price that fits their budget and meets their needs.”
Cameron noted that currently, under the ACA, Idahoans can legally purchase short-term, 10-month insurance plans with 12-month pre-existing condition exclusions, and 3,500 have done so. The new state-based plans will be a better option, he said, with better coverage.
Otter said the executive order follows the lead of President Trump’s health care executive order that he issued on the day he was inaugurated. “The first thing they want to do is allow the states to be the architects of their own insurance markets within their states,” Otter said. “And that’s what we’re doing. We just seized the opportunity and we said, ‘OK, what will work, what will make it work in Idaho?’”
Little said, “To me, it’s a very Idaho thing to do, to not basically suffer under the weight of Obamacare, but to really find an Idaho-centered solution to make health care affordable for our population.”
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