Republicans didn’t get a chance to repeal ObamaCare in 2017, but at least one state has decided to test how far the Trump administration will go in enforcing it. After HHS signaled that states might be able to allow the sale of non-ACA-compliant plans, Idaho decided to take the leap. Now, NPR reports, Blue Cross has launched several new plans tailored to the needs of those who have balked at buying health insurance in the past.
That’s the kind of innovation that ObamaCare punished. Will it do so again?
It’s barely been two weeks since Idaho regulators said they would allow the sale of health insurance that doesn’t meet all of the Affordable Care Act’s requirements — a controversial step some experts said would likely draw legal scrutiny and, potentially, federal fines for any insurer that jumped in.
And on Wednesday, Blue Cross of Idaho unveiled a menu of new health plans that break with federal health law rules in several ways, including setting premiums based on applicants’ health.
In its announcement, Blue Cross emphasized their commitment to consumer choice:
Blue Cross of Idaho designed each new state-based plan to provide access to high-quality healthcare, with the right level of benefits for each member. If approved by the Idaho Department of Insurance, consumers can purchase Freedom Blue plans through Blue Cross of Idaho. Following the DOI’s guidelines, Blue Cross of Idaho will continue to offer ACA plans through Your Health Idaho.
“This is about affordability and choice,” said Maher.
Freedom Blue plans allow Idaho residents to choose the benefits they want at premiums that cost up to 50-percent less than similar ACA-qualified health plans. (Please see the attached summary of Freedom Blue plans.)
Each Freedom Blue plan provides access to prescription drug coverage, doctors, specialists, emergency services, urgent care, hospitals, physical therapists and much more. Freedom Blue plans use the same Blue Cross of Idaho’s guided health networks as its ACA qualified health plans.
That sounds like a healthy market, with new products shaped by consumer demand and pricing pressures. Ten years ago, health insurers created and maintained a wide variety of plans that allowed consumers to get maximum value for their premiums, calculating the necessity of coverages against their individual needs and economic situations. ObamaCare, with its one-size-fits-all coverage mandates and misguided community ratings, demolished that flexibility and made it impossible for healthier Americans to get much value out of their insurance.
However, NPR wonders just how long that system can last if HHS allows Idaho to shelter illegal plans in their state:
The Blue Cross decision ups the ante for Alex Azar, the Trump administration’s new Health and Human Services secretary. Will he use his authority under federal law to compel Idaho to follow the ACA and reject the Blues plans? Or will he allow state regulators to move forward, perhaps prompting other states to take more sweeping actions?
At a congressional hearing Wednesday, even as Blue Cross rolled out its plans, Azar faced such questions. “There are rules,” Azar said. “There is a rule of law that we need to enforce.” …
“Crazypants illegal,” tweeted Nicholas Bagley, a law professor at the University of Michigan and former attorney with the civil division of the U.S. Department of Justice, who said that states can’t pick and choose which parts of federal law to follow. Sabrina Corlette, a research professor at Georgetown University’s Center on Health Insurance Reforms, pointed out that health insurers could be liable for sharp fines if they are found to be in violation of the ACA.
Oh, we’re suddenly concerned about the enforcement of every federal law and regulation, are we? Here’s a proposal that I think would suit everyone. Donald Trump could issue an executive order relying on the administration’s prosecutorial discretion that directs HHS and other agencies to postpone any action on enforcing these regulations. The administration could argue that while these plans may well be technically illegal, they also appear to be working well in these communities. They serve usefully to assist taxpayers in improving their lives despite their lack of proper provenance. The plans aren’t causing trouble, at least not any more than any other plans in Idaho.
But what shall we call this program? Perhaps we can call it Deferred Action on the Affordable Care Act, or DAACA for short. Who’s with me?
Bagley’s correct, of course, and Azar is supposed to enforce the laws and regulations of ObamaCare. But it’s a hoot to hear that states and cities have to abide by every jot and tittle of the ACA and its regulations while others celebrate sanctuary cities, and insist on calling illegal immigrants “dreamers” while devising new ways to undermine actual and specific federal immigration laws. For that matter, how about those who insist that states should be the “laboratories of democracy” when it comes to marijuana but not health insurance? Prosecutorial discretion for we and not for thee, apparently.
In regard to Idaho and Blue Cross, HHS will likely get sued into enforcement at some point. It’s still a great example of what our health insurance market could look like if Congress had done what it promised to do and repeal ObamaCare.