Blue Cross of Idaho will being to offer plans that do not comply with Obamacare's basic regulations after a change by the state's government.

The so-called Freedom Blue plans would cap the benefits a person could receive in a year and charge people more due to a preexisting condition.

Neither of those features are permitted under the Affordable Care Act.

It is unclear whether the Department of Health and Human Services will step in and prevent Idaho from selling these plans.



Blue Cross of Idaho announced Wednesday it would take advantage of the state's new loophole for Affordable Care Act regulations, prompting questions over how the Trump administration will respond.

In January, Idaho's government announced it would allow insurers to offer "state-based plans" that did not adhere to regulations set out by the Affordable Care Act, or Obamacare.

The plans would not have to cover all essential health benefits, which are 10 items of basic care areas any ACA plan must provide. They could charge people more based on their health history. Both of those conditions currently disqualify a plan from being sold on Obamacare's exchanges.

Blue Cross Idaho, the largest Obamacare insurer in the state, said it plans to start selling "Freedom Blue" plans that do not comply with the regulations. The company will continue to offer ACA-compliant plans, which is required by Idaho to sell the less-regulated options.

According to The Wall Street Journal, the monthly premium for a 45-year-old under a "Freedom Plan" would vary from $194.67 to $525.69, depending on preexisting conditions and other health risks. The current bronze level ACA-compliant plan from the insurer runs about $343.09 a month.

These plans would also cap the benefits an individual could receive at $1 million a year, again violating the ACA's rules.

It's unclear how the Trump administration will respond

The Department of Health and Human Services has followed President Donald Trump's directions by allowing states to loosen regulations on Obamacare marketplaces. But the Idaho plan is the most envelope-pushing plan yet.

Larry Levitt, a senior vice president at health policy think tank The Kaiser Family Foundation, tweeted that the Idaho plan is clearly flouting the law.

"Idaho is allowing health insurance plans that charge sick people more than healthy people, have an annual limit on coverage, and don’t cover maternity care," Levitt said. "That’s simply not allowed under the ACA."

Levitt said that while this may lower premiums for some healthy people, many "middle-class people with preexisting conditions will pay more."

HHS is required by the ACA to step in and take over regulation of any state that does not meet regulatory standards, and the department has done so in four states already.

Asked about the Idaho situation during a hearing before the House Ways and Means Committee, HHS Secretary Alex Azar said no one from Idaho has contacted the HHS about a waiver. When that happens, he said, the department could step in.

"We will look at that whenever it comes to us, of course there are rules and there's a rule of law that we need to enforce," Azar said.

Levitt said that if HHS does not intervene in Idaho, the changes would likely open the door to more loosely regulated plans and allow state regulators to undermine ACA exchanges in their own states.

"If HHS does not step in and enforce the ACA's insurance rules in Idaho, it won't just be about Idaho," he said. "Other conservative states will no doubt then start to allow insurance plans that don't comply with the ACA."