Under the new state rules, insurers in Idaho would still have to offer policies that comply with the Affordable Care Act on the state’s health insurance exchange, a web-based marketplace for individual and business plans. But in policies sold outside that exchange, Idaho insurers could omit some of the benefits required by the Affordable Care Act. Under the guidelines that emerged from Idaho’s executive order, those policies would not have to comply with federal limits on out-of-pocket costs and they could impose caps on the dollar amount of benefits available to consumers.

Some people with pre-existing conditions could be denied coverage for up to 12 months if they had not maintained “continuous prior coverage.” And insurers could in some cases charge different rates based on a person’s health status. Insurers would be able to ask consumers if they have had any of numerous medical conditions, including cancer, heart disease, diabetes, AIDS and asthma.

Some groups representing patients, including the American Heart Association, the American Diabetes Association and the lobbying arm of the American Cancer Society, have denounced Idaho’s plans, saying they fear that some people will actually end up paying more. The new, cheaper plans would appeal to the healthiest people, they said, leaving less healthy people in a shrinking pool of people seeking coverage that meets the Affordable Care Act standards.

“A.C.A. premiums would increase, and options for individuals with pre-existing conditions would narrow,” the American Academy of Actuaries, a nonpartisan professional group in Washington warned in a letter to the Idaho Department of Insurance.

Gary Ottman, a farmer in south-central Idaho who sells malt barley to the brewers of Coors beer, said he just wanted something that works.

“With being self-employed, you can’t go on a group plan, and you’re pretty much like a lone wolf out there — they pick you apart,” said Mr. Ottman, 60. He said that he was satisfied for a while under an Affordable Care Act policy that he bought for himself and his wife, Teresa. But then their premiums soared to more than $900 a month, he said, with a $7,500 deductible before a first claim would be paid. Politicians who promise to fix the system and don’t follow through, including Congress with its failed efforts to repeal the health care law, are part of the problem, Mr. Ottman said.