A top-ranking Democrat has asked Health and Human Services Secretary Alex Azar to tell him within the next 30 days how he will go about intervening with Idaho’s plan to upend its Obamacare marketplace.
During a Senate Finance Committee hearing aimed at discussing President Trump’s budget, Sen. Ron Wyden, D-Ore., slammed Idaho’s proposal to offer health insurance plans that don’t comply with the mandates and protections obligated under Obamacare. State officials have announced insurers will be allowed to sell plans that exclude certain services, like maternity coverage, and they can charge enrollees more based on medical status.
Obamacare does not allow for these types of plans to be sold, so it’s unclear how Idaho is proceeding and whether what they are proposing will pass legal scrutiny. The case is being closely watched by other state officials because the prices of premiums are expected to continue to climb.
Idaho Blue Cross has unveiled its intention to sell the types of plans the state would allow, according to media reports. Azar said he had not seen any formal applications and had only read about the move in the news.
“I don’t want to be prematurely involved until there is a matter of controversy at the state level,” he said. “All we’ve seen is a press report. I don’t know whether it would even be approved by Idaho or certified by [Obamacare].”
Wyden initially asked Azar to have a plan back to him within 10 days but Azar said he couldn’t commit to that because he didn’t know whether Blue Cross had submitted a formal application federal officials could review and receive. He also indicated he believed Idaho would be submitting a waiver, which is a provision Obamacare offers to give states some flexibility, but state officials have given no indication that is their intention.
“They are not planning to come to you and ask permission,” Wyden said. “They have made the argument that they can just do it on their own. So the idea that we can just sit back here in our offices and wait for someone to tell us … that will not cut it with me.”
He accused the state of breaking federal law and said the provisions looked at would discriminate against people with pre-existing illnesses, like cancer or diabetes.
Sen. Mike Crapo, R-Idaho, sided with Azar’s wait-and-see approach.
“I think it is appropriate wait to see what is developing and watch it carefully,” he said. He resisted the characterization by Wyden and other Democrats that anytime Republicans look to change the healthcare system they are refusing coverage for pre-existing illnesses.
“I don’t see a violation here at all,” Crapo said, adding he believed the state was only seeking flexibility. He noted Idaho would mandate insurers offer at least one plan that met Obamacare’s requirement, “allowing others to have options.”
“The idea that that as a direction is something we should choke off from the very beginning is an idea that I resist,” he said.
Azar agreed states needed more flexibility and said Obamacare plans had become too expensive for many customers, particularly those who do not receive federal subsidies.
“I think what we are seeing here is a cry for help,” Azar said. “It’s saying that where we are right now with our individual market because of the structure we have is not serving enough of our citizens. There are too many Americans who simply cannot afford the insurance packages we have in our program because of the way the statute is designed and the way it has been implemented.”
