Idaho's Gov. Butch Otter (Republican, of course) is moving ahead with his wildly illegal plan to ignore the Affordable Care Act's consumer protections and allow insurers in the state to sell crappy plans. The problem, of course, is constitutional. The Supremacy Clause is pretty darned clear in that states can't just ignore federal law. Since the ACA has not been repealed, it's federal law. But here we go: the executive order has now been put into a plan.
What they want to allow insurers to do would pretty much overturn the key things Obamacare has banned: Impose pre-existing condition exclusions for people who were uninsured; charge higher premiums for sick people; and exclude certain benefits. They think they can do this because, well, because they are idiots? It's probably because they're Idaho Republicans and this is "taking on the jack-booted thugs" of the federal government who want people to be healthy. "There are other states that have been talking about it, but we may be out in front," says Department of Insurance director Dean Cameron. "They may look to follow us should be we successful."
What it means is that the state will end up back in court, a pretty common occurrence here because there's nothing the Idaho Republicans love more than spending taxpayer money on ridiculous court fights.
The guidelines raised concerns for some organizations. Lupe Wissel, AARP's Idaho director, said in a statement that allowing insurance carriers to charge older customers as much as five times more than others for premiums amounts to an age tax.
And Mistie Tolman, Idaho legislative director of Planned Parenthood Votes Northwest and Hawaii, called the new guidelines "a direct attack on women of all ages."
"The move has been considered 'legally dubious' and follows a pattern in the state by elected officials who introduce policies that are harmful and unconstitutional and necessitate costly legal battles," she said in a statement. […]
Robert Laszewski, a health policy consultant, doesn't think Idaho's approach can stand up in court, even if federal oversight agencies decide to let it move forward. The Affordable Care Act is the law of the land, he said, and has been upheld by the U.S. Supreme Court.
There will be legal battles. It seems very likely that new Trump Health and Human Services director Alex Azar would be more than happy to give the state a waiver. But as Laszewski says, "They might even get a federal waiver, but the problem is the state's going to get taken to court by Obamacare advocates. The Trump administration can look the other way, but courts can't look the other way."