Idaho First to Offer State-Based, Non-ACA Health Plans

Without obtaining federal permission, Idaho has announced plans to allow health insurers to offer policies that do not adhere to the standards of the Affordable Care Act (ACA), provided they also offer ACA-eligible plans.

idaho-to-offer-non-aca-health-plansAccording to the Idaho Department of Insurance:

Governor C.L. ‘Butch’ Otter and Lieutenant Governor Brad Little issued Executive Order No. 2018-02 on January 5, 2018, directing the Department of Insurance to seek creative options which will expand Idahoan’s access to insurance and to approve plans meeting state requirements even if not all requirements of the Patient Protection and Affordable Care Act are met, so long as the carrier proposing such a plan also offers exchange-certified plans.

The new plans can exclude pre-existing conditions for up to 12 months unless the insured can prove continuous prior coverage. The plans can also cap services at $1 million, and can have different out-of-pocket maximums for different services — one for prescriptions, another for doctors’ visits and still another for hospitalizations. They can also exclude some of the ACA’s essential health benefits, such as maternity and newborn care.

Idaho Department of Insurance Director Dean Cameron said the move is necessary to make cheaper plans available to more people. Otherwise, he said he fears the state’s individual health insurance marketplace will eventually collapse as healthy residents choose to go uninsured rather than pay for expensive plans that comply with the federal law.

“There are other states that have been talking about it, but we may be out in front,” Cameron said. “They may look to follow us should be we successful.”

With the ACA’s individual mandate — be insured or pay a tax fine — expiring next year, cheaper policies may attract the young and healthy who otherwise might go uninsured.

NOTE: The details in this blog are provided for informational purposes only. All answers are general in nature and do not constitute legal advice. If legal advice or other expert assistance is required, the services of a competent professional should be sought. The author specifically disclaims any and all liability arising directly or indirectly from the reliance on or use of this blog.
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