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Q&A: Idaho is 'pushing the envelope' with health insurance plan. Can it do that?

Julie Appleby, Kaiser Health News on

Published in Health & Fitness

Q: Can Idaho do this?

A: Many experts say no. Nicholas Bagley, a law professor at the University of Michigan and former attorney with the civil division of the U.S. Department of Justice, tweeted last week that the move was "crazypants illegal."

In a follow-up call, he explained that the ACA created rules that -- among other things -- prevent insurers from discriminating against people based on their health or excluding coverage for those conditions.

"I'm completely flummoxed," he said. "Idaho appears to be claiming they do not have to adhere to federal law."

But Idaho officials believe there's precedent for what they are doing, pointing to actions taken by President Barack Obama when he promised people that if they liked their health plans, they could keep them. Obama issued an executive order directing his agencies to allow the continuance of some plans purchased before the marketplaces opened -- even though they fell short of ACA rules, Cameron noted.

Additionally, Cameron pointed to state laws that allow insurers to sell short-term policies that don't meet all the ACA rules.

"We have tried to do everything we can to adhere to and follow the requirements," said Cameron, who added that the state consulted with administration officials as it developed its plan.

"I recognize we are pushing the envelope a bit," he said. "We think this is what is needed."

Q: What might happen?

A: Most experts expect that a lawsuit is likely, perhaps on behalf of someone with a pre-existing condition alleging harm because the state-based plans will cost the sick more or limit coverage in other ways.

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