By Dan Calabrese ——Bio and Archives--February 19, 2018
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The executive order signed in early January by Gov. Butch Otter and Lt. Gov. Brad Little would let insurers bring new plans to market that break the rules of the Affordable Care Act. The proposal would create a separate health insurance market using many of the rules Idaho insurers followed before Obamacare. Though that’s been considered forbidden since the ACA passed, one state official says the Trump administration isn’t pushing back on the idea. “We’re not just pulling these things out of our hat,” Dean Cameron, director of the state Department of Insurance, told the Statesman last week. “We’re using Idaho law as the foundation for them.” Officials are referring to the plans as “state-based.” Under additional guidance issued Jan. 24, insurers can:
As much as I would love to see Idaho get away with this, the Trump Administration would cause far too many other problems by doing so.In maybe the biggest change, a person can end up paying higher premiums because of a history or high risk of expensive medical conditions. In order to get the state-based plans, people can be required to fill out a questionnaire that asks about past health care claims, disorders and treatments, ranging from the near-universal – allergies, depression/anxiety, arthritis – to the less common – a stem-cell transplant or spina bifida.
- carve out benefits, like maternity coverage. However, any insurer offering state-based plans must have at least one with maternity, which includes prenatal care.
- restore co-pays for preventive care, such as colonoscopies.
- limit annual claims to $1 million, at which point those high-cost patients would be moved onto ACA-compliant plans sold through Idaho’s health insurance exchange.
- deny coverage for pre-existing conditions, to a limited degree.
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