After the Centers for Medicare and Medicaid (CMS) gave the state a hard “no” on its plans to allow insurers the option to sell plans on the individual market that don’t comply with the Affordable Care Act (ACA), discussions continue.
Details about how the state will manage premiums and other ACA regulations have so far been hidden from public view, but CMS made it clear that Idaho’s strategy to open up the market to individual plans that don’t include the 10 essential ACA benefits was illegal.
Idaho Department of Insurance Director Dean Cameron argues the “state-based health benefit plans” or “state-based plans” are necessary because Idaho consumers are facing high premiums and deterring healthy residents from getting health insurance.
Before shooting down the non-compliant ACA plans, CMS Administrator Seema Verma wrote in her decision letter to Cameron, “We sincerely appreciate your dedication to the people of Idaho and your efforts to address the damage caused by the PPACA.”
Verma also expressed her agency’s desire to offer flexibility to states seeking changes to the individual health insurance market, indicating that Idaho’s plan may just need some tweaking.
“we believe that, with certain modifications, these state-based plans could be legally offered under the PHS Act exception for short-term, limited duration plans,” wrote Verma. “I encourage you to continue to engage in a dialogue with my staff regarding this and other potential options.”
Read the January 2018 bulletin that got the discussion started and describes the provisions Cameron outlines for Idaho insurers offering state-based health plans.
Read a Kaiser Family Foundation news brief that examines short-term limited duration policies and Idaho’s efforts to create health plan options outside of ACA requirements.
The Associated Press broke down some sticking points within Idaho’s proposal
Read more from the Moscow-Pullman Daily News