CMS denies Idaho bid to sell plans not compliant with ACA
- CMS on Thursday rejected Idaho's bid to allow the sale of insurance not in compliance with the Affordable Care Act, saying it would fail to substantially enforce what remains the law of the land.
- Despite the denial, CMS Administrator Seema Verma wrote to Idaho Gov. C.L. "Butch" Otter and Idaho Insurance Department Director Dean Cameron that "this is certainly not our preference," saying the state could meaningfully implement many of the same goals legally through short-term, limited-duration plans. The administration recently issued a proposed rule looking to expand such plans and allow consumers to buy short-term plans for a full year rather than the current limit of three months.
- Blue Cross of Idaho announced last month it would seek to sell five plans that sidestep the ACA. The CMS action comes after Democratic lawmakers pressured HHS Secretary Alex Azar during a series of budget hearings to step in and address Idaho's plan.
In a press conference with reporters Thursday, Azar said the administration believes consumers should be able to renew short-term, limited-duration plans for more than one year. Azar said HHS would work with Congress to get clearer authority to offer renewable plans if needed.
“CMS is committed to working with states to give them as much flexibility as permissible under the law to provide their citizens the best possible access to healthcare," Verma said in a statement on her letter to Idaho.
(3/3) Based on our review of the Idaho Bulletin, @CMSGov has reason to believe that Idaho would be failing to substantially enforce the provisions in Part A of title XXVII of the Public Health Service Act (the Part A market requirements) as amended by the ACA.— Administrator Seema Verma (@SeemaCMS) March 8, 2018
House Energy & Commerce Ranking Member Frank Pallone, D-NJ, praised CMS for stepping in, but called out the Trump administration for continuing to sabotage the ACA.
“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 preexisting conditions," Pallone said in a statement. "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."
Verma wrote that Idaho has 30 days to respond to CMS about its concerns Idaho may not be substantially enforcing the Public Health Service Act based on the Bulletin.
"Notwithstanding our concerns regarding the Bulletin's inconsistency with the Part A market requirements, 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," Verma wrote.
But the insurance and hospital lobbies have both raised concern over the Trump administration's plan to expand such short-term plans, saying the proposal would lead to higher premiums for those with pre-existing conditions.
"These products would appear cheaper to consumers, but would do so at a significant cost: by covering fewer benefits and ensuring fewer patient protections, such as coverage of pre-existing medical conditions," American Hospital Association President and CEO Rick Pollack said in a statement on the proposed short-term health insurance plans.
"In addition, the expansion of these types of plans could undermine the individual market by concentrating the risk of less healthy individuals in those markets, driving up the cost of comprehensive coverage. Many vulnerable individuals who rely on the marketplaces for comprehensive coverage could be left without affordable options," he added.
- CMS Verma letter to Idaho
- Healthcare Dive Trump short-term health plan may spur more ACA exits
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