Democrats Question Legality of Idaho Decision to Allow Junk Health Insurance, Call on HHS to Enforce Law

Top House and Senate Democratic health leaders today called into question the legality of Idaho's reported plan to allow health insurers to offer "state-based plans" that do not meet consumer protections required under federal law. In a letter sent to Trump Administration officials, the lawmakers expressed concern that such plans will allow insurers to offer health plans that skirt consumer protection requirements of the Affordable Care Act and deny coverage to those with pre-existing conditions, pregnant women, and patients who are older and sicker. They called for the release of any communications or legal justification exchanged between the federal government and the state.

The letter to Health and Human Services (HHS) Secretary Alex Azar and Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma was signed by House Energy and Commerce Ranking Member Frank Pallone, Jr. (D-NJ), House Ways and Means Ranking Member Richard Neal (D-MA), Senate HELP Ranking Member Patty Murray (D-WA), and Senate Finance Ranking Member Ron Wyden (D-OR).

To date there has been no public confirmation that the State of Idaho received Federal approval prior to releasing its guidelines. The state's guidelines appear to be in violation of federal law under the Affordable Care Act, which protects consumers with pre-existing conditions, guarantees pediatric dental and vision coverage, and prevents insurers from charging consumers more for maternity and newborn care.

"The State of Idaho's new guidelines eviscerate critical protections that are enshrined in Federal law and have the potential to destabilize the health insurance market and raise premiums for thousands of consumers and families in the State of Idaho," the Democrats wrote in their letter to Secretary Azar and Administrator Verma. "Consumers in so-called ‘state-based plans' will lose access to coverage for critical services, and these plans will drive up costs for people who purchase insurance that satisfies Federal consumer protections, harming those who need health care most."

The Democrats continue in their letter, "We seek to understand how the U.S. Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) worked or plan to work with the State of Idaho to ensure that plans comply with Federal law so that consumers in Idaho benefit from the same protections as consumers in every other state."

As part of their inquiry, the Democrats are also requesting a series of official documents from the Trump Administration, including:

• If HHS and/or CMS believes that the guidelines are in full compliance with Federal law, please provide any documents that provide the legal justification.
• All communications between HHS and/or CMS officials and officials from the Idaho Department of Insurance, the Idaho Department of Health and Welfare, the Office of the Governor of Idaho, or other state employees and/or affiliated consultants in which the new guidelines were discussed or mentioned.
• Any analysis HHS and/or CMS has performed to evaluate the effects that the Idaho Department of Insurance's new guidelines would have on coverage and market stability in the State of Idaho.
• Any analysis the State of Idaho performed to evaluate the effects of the Idaho Department of Insurance's new guidelines that was submitted to HHS and/or CMS.

A copy of the letter is available HERE.

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