How Blue Cross of Idaho's new plans bring back pre-ACA insurance design

Weeks after Idaho announced it would allow the sale of insurance plans that don’t comply with Affordable Care Act (ACA) regulations, an insurer will offer coverage which violates the existing law.

The Idaho Statesman reported that Blue Cross of Idaho has asked for approval for five of these “state-based” plans, which could be available to customers beginning in March. Under the parameters set by an executive order by Idaho Gov. Butch Otter, plans could ignore ACA regulations by denying coverage based on pre-existing conditions or dropping some of its required health benefits. The Blue Cross plans keep the ACA’s essential benefits (with the exception of one plan which excludes maternity care) but will charge more based on pre-existing conditions and have a $1 million annual limit on claims.

Premiums could be substantially lower, Blue Cross said, with a $4,000 deductible plan costing as little as $89.91 per month, compared to $237.60 for a similar plan on the ACA exchange. Dave Jeppesen, executive vice president of consumer healthcare at Blue Cross, argued these plans would stabilize the individual market, not siphon away healthier customers—and he isn’t worried about the insurer being sued.

“This is something we have stared at through every lens, including the legal side,” Jeppesen said. “The ACA, when it was set up, gave the regulatory authority to the state, and the state is charged with substantially enforcing the ACA. … We didn’t make these decisions, right? The governor gave the order and [the Idaho Department of Insurance] gave the guidance. … The way the law is set up, that’s our regulator.”

HHS Secretary Alex Azar, who has been a frequent critic of the ACA, hasn’t said whether the agency will get involved with Idaho’s policy, though he did say at a congressional hearing on Feb. 14 that “there’s a rule of law that we need to enforce.”

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