Idaho defies ObamaCare by permitting noncompliant plans . . . and the Trump Administration has to stop them

I'll admit to you that when I first read about this, I was cheering Idaho on. It seemed both heroically defiant and strategically shrewd. The federal government should not be telling states how to fashion their health care laws, and the manner in which ObamaCare does so is foolish to an extreme. So what should a state do? Simple: Pass the sane, sensible laws you should have every right to pass, then sit there and dare the federal government to stop you. You've got an administration that probably agrees with you on the merits, so why not essentially nullify ObamaCare by defying it. Let the Trump Administration exercise "prosecutorial discretion" as it were, and just like that, you've established the precedent that states are free to flout the law.

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Yes! I pumped my fists. This is the way to do it. Except that I know that's not true. After waxing philosophic about how an attorney general can't just pick and choose the laws he wants to enforce, I know the same thing applies here. If states just ignore the law and the White House just refuses to do anything about it, the problem is really not solved, however appealing this might be:

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:

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• 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.

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.

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.

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For starters, it would validate every decision Barack Obama made to simply ignore laws he didn't like, which conservatives said was a question of respecting his constitutional oath. If it was a travesty for Obama to ignore immigration and marijuana laws, then it's every bit the same travesty for Trump to ignore ObamaCare. Also, it would let Congress off the hook for its failure to repeal it. Congress created this problem in 2010. Congress needs to solve it in 2018. Simply pretending the law doesn't exist leaves both the present Congress and future Congresses with no incentive to do a real repeal. Furthermore, some day there's going to be a Democrat president again, and if the law is still on the books then every state that's been flouting it during the time of Republican rule is in for some very big trouble. You're not really solving anything as long as the executive authority to enforce ObamaCare remains on the books. Finally, this approach would further contribute to the general disregard we're seeing in this country for law. That is not a good thing, even if you don't like the laws that are being ignored. But someone doesn't like the laws you do like, and wants the same freedom to ignore them. Pretty soon there basically is no law, and once that happens the politicians on Capitol Hill can pretty much wash their hands of all responsibility, since no one does what they say anyway. It won't be fun to watch the Trump Administration put the kibosh on Idaho. But it's their job, and this isn't the way to solve the problem.

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