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Trump Administration Tells Idaho It Will Enforce Affordable Care Act if State Refuses

The Trump administration will step in to enforce the Affordable Care Act’s requirements in Idaho if the state doesn’t back down on its plan to allow the sale of skimpier, less expensive insurance products, a top health official told Idaho on Thursday.


Centers for Medicare and Medicaid Services administrator Seema Verma, seen here with President Donald Trump in the White House last year, has sent a letter to Utah’s governor and insurance commissioner enforcing the 2010 health law. Photo: Evan Vucci/Associated Press

By

Louise Radnofsky

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WASHINGTON—The Trump administration will step in to enforce the Affordable Care Act’s requirements in Idaho if the state doesn’t back down on its plan to allow the sale of skimpier, less expensive insurance products, a top health official told Idaho on Thursday.

“We sincerely appreciate your dedication to the people of ldaho and your efforts to address the damage caused by the PPACA,” wrote Seema Verma, the administrator of the Centers for Medicare and Medicaid Services. Her agency oversees implementation of the 2010 health law, formally called the Patient Protection and Affordable Care Act and popularly known as Obamacare.

  • Seema Verma’s March 8 letter to Utah

“This Administration recognizes and supports the fundamental role states play in regulating insurance. We further recognize that states face unique challenges in repairing the individual health insurance market and we are committed to working with states to provide flexibility to do so,” Ms. Verma’s letter says. “However, the PPACA remains the law and we have a duty to enforce and uphold the law.”

Idaho officials, including the governor, released a statement Friday saying they will consider all options and continue discussions with the Trump administration.

“Contrary to news media interpretations, the letter from CMS Administrator Verma was not a rejection of our approach to providing more affordable health insurance options for the people of Idaho,” the statement said. “Her letter made it clear that Idaho’s efforts to pursue innovative alternatives hold great promise, and we believe that Idaho’s plan aligns with the state’s responsibility for ‘substantially enforcing’ Obamacare.”

The standoff between the red state with a troubled insurance market and a Trump administration wrestling with how to enforce a law it spent much of 2017 trying to overturn has lasted for several weeks. Idaho officials pressed to make their case to Washington leaders, including new Health and Human Services Secretary Alex Azar.

Related

  • Federal Agency Sidesteps Idaho Dispute on Health Insurance (Feb. 15)
  • Idaho Insurer to Sell Plans at Odds With Federal Health Law (Feb. 14)
  • Idaho to Allow New Insurance Plans Outside of Federal Health Law (Jan. 25)
  • Iowa Halts Effort to Overhaul Affordable Care Act (October 2017)
  • States Watch Iowa’s Push to Reshape Health Law (August 2017)

Idaho’s Department of Insurance said in January it would allow insurers in the state to begin offering products that left out some of the benefits mandated by the ACA for individual coverage.

Insurers would be able to consider enrollees’ medical history in setting their premiums, a practice known as underwriting, which isn’t authorized under the ACA. New state-based plans also could include dollar limits on total benefit payouts, which the ACA banned.

The eight-page letter from Ms. Verma to Idaho Gov. Butch Otter and Insurance Commissioner Doug Cameron outlines several provisions the Trump administration sees as falling afoul of the federal law. Ms. Verma says that under new rules proposed by the Trump administration to expand the availability of short-term, limited-duration plans, the state may have some flexibility to allow the sale of skinnier benefits if it makes certain modifications to fit that definition.

Democrats quickly cheered the move, while swiping at the Trump administration’s recent proposals on short-term, limited-duration plans.

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“I’m glad to see CMS enforced the law and rejected this outrageous and clearly illegal attempt by the State of Idaho to eliminate critical consumer protections in the Affordable Care Act, such as the protections for people with pre-existing condition,” said Rep. Frank Pallone of New Jersey, the top Democrat on the Energy and Commerce Committee.

“Make no mistake, however, while this is the right decision, the Administration continues its many efforts to undermine the law and chip away at its protections, including by encouraging Idaho to sell junk plans in another way.”

—Anna Wilde Mathews contributed to this article.

Write to Louise Radnofsky at louise.radnofsky@wsj.com

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