If Idaho ditches ACA, other states may follow

Wendell Potter
Posted 2/21/18

What happens in Idaho in the coming weeks undoubtedly will not stay in Idaho. What happens there could make a big difference in how much you pay for your health insurance – or whether you can even get insurance.

This item is available in full to subscribers.

Please log in to continue

Log in

If Idaho ditches ACA, other states may follow

Posted
What happens in Idaho in the coming weeks undoubtedly will not stay in Idaho. What happens there could make a big difference in how much you pay for your health insurance – or whether you can even get insurance. 
Idaho’s Republican governor, C. L. “Butch” Otter, signed an executive order last month that, if not blocked by the federal government, will do what Republicans in Washington have not been able to do: turn the clock back to the days before the Affordable Care Act, at least in the state’s individual health insurance market. 
The only significant change to the ACA that members of Congress have been able to enact so far is the removal of the penalty Americans must pay to stay uninsured. That was accomplished through a provision of the recently enacted tax reform law. Otter said he viewed the repeal of the penalty as a green light for states to make much more far-reaching changes to rules governing the sale of health insurance.
“Congress and President Donald Trump have eliminated the individual mandate requiring all Americans to buy Obamacare plans or face financial penalties,” Otter said when he announced the executive order on Jan. 5. “That means we will no longer be penalized for buying coverage that doesn’t meet all the Obamacare rules. Now the door is open for states to pursue our own reasonable solutions.” He said his move would give consumers more choices and lower their insurance costs.
Otter’s executive order would allow health insurers to once again sell policies – and engage in practices – that were made unlawful by the ACA. Under the proposal, insurers in Idaho would once again be able to charge applicants who are ill or who have pre-existing conditions considerably more than what they charge healthier people. Insurers would also be able to turn down prospective customers because of their health status. 
Applicants would be required to complete a questionnaire detailing their health status and past health claims. Based on the answers, insurers’ underwriters would determine how much to charge applicants – if they were willing to sell them coverage at all.
If the Trump Administration allows the state to move forward, Idaho’s youngest and healthiest residents could soon be paying less for health insurance. Older and less healthy Idahoans, however, could be paying much more.
Insurers would also once again be able to charge co-payments for preventive care and set a $1 million annual cap on claims. And they could sell policies that do not cover maternity care. That could result in many women in Idaho once again paying more for coverage than men.
Lawmakers in other states will be looking very carefully at what happens in Idaho. If the Trump administration allows the governor’s idea to move forward and the plan survives any lawsuits that likely would be filed, other states might follow Idaho’s lead.