Yesterday, the Trump Administration confirmed that Idaho’s Affordable Care Act end-run is wildly illegal. Even so, CMS encouraged Idaho to explore other ways to sabotage the law.
Here’s a roundup of reactions to the Trump Administration’s continuing bad faith on protecting Idahoans’ health care:
Idaho Statesman: “With Some Modifications, The Noncompliant Plans Could Be Turned Into Short-term Plans For Customers.”
“Verma said her agency was sympathetic to Idaho officials’ concerns, and said President Trump is ‘committed to doing everything in his power to increase competition, choice, and access to lower-priced, high-quality health care options for all Americans.’ ‘As you know, the Patient Protection and Affordable Care Act (PPACA) is failing to deliver quality health care options to the American people and has damaged health insurance markets across the nation, including Idaho’s,’ Verma wrote, noting that premium rates for coverage through the Idaho health insurance exchange have increased by more than 91 percent from 2014 to 2018, while insurance companies continue to incur losses. Verma also outlined some options that she believes Idaho could legally take under a recently proposed federal rule. That rule would expand the availability of short-term, limited duration health insurance by allowing consumers to buy short-term plans that would cover them for just under a year. She said that with some modifications, the noncompliant plans could be turned into short-term plans for customers.” [Idaho Statesman, 3/8/18]
Sen. Ron Wyden: “While They Claim To Be Upholding The Law, They Are Explicitly Inviting Idaho And Other States To Sell Short-term, Junk Insurance — The Exact Opposite Of The Protections Put In Place By The Affordable Care Act.”
“ObamaCare supporters were pleased but not overly impressed by the CMS move. ‘The Trump administration is talking out of both sides of their mouth,’ said Sen. Ron Wyden (D-Ore.). ‘While they claim to be upholding the law, they are explicitly inviting Idaho and other states to sell short-term, junk insurance — the exact opposite of the protections put in place by the Affordable Care Act.’” [The Week, 3/8/18]
New York Times: “Verma Said That Idaho Had Other Options And Could Perhaps Achieve Much Of What It Wanted To Do Under A Regulation Proposed Last Month By Mr. Trump.”
“While rejecting the Idaho plan in its current form, Ms. Verma encouraged the state to keep trying, and she suggested that ‘with certain modifications,’ its proposal might be acceptable… Ms. Verma said that Idaho had other options and could perhaps achieve much of what it wanted to do under a regulation proposed last month by Mr. Trump.” [New York Times, 3/8/18]
Washington Post: “‘We Sincerely Appreciate Your Dedication To The People Of Idaho And Your Efforts To Address The Damage Caused By The [ACA],” Said The Letter.”
“The four-page letter to Idaho Gov. C. L. “Butch” Otter (R) and Cameron, made public early Thursday evening, straddles the Trump administration’s antipathy for the ACA with its need to enforce the sprawling 2010 health-care law that is a path to insurance coverage for millions of Americans. ‘We sincerely appreciate your dedication to the people of Idaho and your efforts to address the damage caused by the [ACA],” said the letter, signed by CMS Administrator Seema Verma. The letter said the president is eager to give states ‘as much flexibility as possible under the law to address the unique needs of their health insurance markets.’” [Washington Post, 3/8/18]
Rep Frank Pallone: “The Administration Continues Its Many Efforts To Undermine The Law And Chip Away At Its Protections, Including By Encouraging Idaho To Sell Junk Plans In Another Way.”
“Democrats cheered the Trump administration’s decision, but they still criticized other actions HHS has taken in recent months to weaken the law. ‘Make no mistake, however, while this is the right decision, the Administration continues its many efforts to undermine the law and chip away at its protections, including by encouraging Idaho to sell junk plans in another way,’ said Rep. Frank Pallone of New Jersey, the top Democrat on the House Energy and Commerce Committee.” [Politico, 3/8/18]
Talking Points Memo: “Verma Notes In The Letter That Enforcing The ACA Is ‘Certainly Not Our Preference.”
“Verma notes in the letter that enforcing the ACA is “certainly not our preference,” and encourages Idaho to find ways within the letter of the law to accomplish the same goals. She specifically advises the state to look into creating short-term health insurance plans—which recently received the Trump administration’s blessing to be sold in violation of the ACA’s regulations. [TPM, 3/8/18]
Bloomberg: “The White House Has Suggested To Congress That People Should Be Able To Renew Short-term Plans Without Being Subject To Medical Underwriting, The Process By Which Insurers Can Exclude Or Charge More For Pre-Existing Conditions.”
“Idaho’s proposal has put the Trump administration in a position it has found itself in before: charged with upholding a law it wants to get rid of, and that it has taken active steps to dismantle. Verma left open the possibility that plans like the state was proposing could be sold in a different form. If they were offered as short-term policies instead of annual coverage, they might be allowable, she said. The administration has pushed short-term plans as a way to offer consumers less expensive, less comprehensive options. In her letter to Idaho authorities, Verma said that ‘with certain modifications, these state-based plans could be legally offered’ as short-term plans. The White House has suggested to Congress that people should be able to renew short-term plans without being subject to medical underwriting, the process by which insurers can exclude or charge more for pre-existing conditions.” [Bloomberg, 3/8/18]
CNN: “Verma [Said] That She Wanted To Work With Idaho And Other States To Repair The ‘Damage’ Caused By The Affordable Care Act.”
“However, Verma did say that she wanted to work with Idaho and other states to repair the ‘damage’ caused by the Affordable Care Act. She suggested that Idaho could legally implement many of its proposals through short-term health insurance plans, which don’t have to adhere to all of Obamacare’s rules. The Trump administration is on course to allow insurers to offer these plans for up to a year, rather than just three months.” [CNN, 3/8/18]
Modern Health Care: “Secretary Alex Azar Told Insurers Thursday That The Trump Administration Will Do What It Can ‘Within The Law’ To Let Insurers Offer More Affordable Plans That Don’t Meet ACA Requirements.”
“The Trump administration on Thursday unexpectedly shot down Idaho’s effort to let insurers sell health plans that don’t comply with the Affordable Care Act’s coverage mandates, thwarting conservative efforts to unravel the law’s consumer protections directly for now. But CMS Administrator Seema Verma indicated that Idaho and other states could achieve the same goal by refashioning such noncompliant health plans as short-term products, which the administration would allow under a controversial proposed rule. HHS Secretary Alex Azar told insurers Thursday that the Trump administration will do what it can ‘within the law’ to let insurers offer more affordable plans that don’t meet ACA requirements. In a letter to Idaho Republican Gov. Butch Otter and state Insurance” [Modern Health Care, 3/8/18]
Washington Times: Verma: “This Is Certainly Not Our Preference.”
“‘If a state fails to substantially enforce the law, the Centers for Medicare & Medicaid Services (CMS) has a responsibility to enforce these provisions on behalf of the State,’ Ms. Verma added. ‘This is certainly not our preference.’ She said Idaho, with some tweaks, might be able to offer similar plans under Mr. Trump’s bid to offer short-term plans for up to a year. There is a GOP effort to codify this change and let people renew these plans, setting up a parallel market for healthier people that could siphon valuable enrollees from Obamacare’s exchanges.” [Washington Times, 3/8/18]
Business Insider: Verma: Idaho’s Attempt “Was Admirable.”
“Verma said that while Idaho’s desire to bring down costs — the stated reason for the policy — was admirable, it was also illegal. ‘CMS is committed to working with states to give them as much flexibility as permissible under the law to provide their citizens the best possible access to healthcare,’ Verma said.” [Business Insider, 3/8/18]
The Hill: “Verma’s Letter Offered Alternatives To The State.”
“Verma’s letter offered alternatives to the state, including embracing a Trump administration move to allow different kinds of cheaper, skimpier insurance plans, known as short-term plans.” [The Hill, 3/8/18]
Vox: “The CMS Letter Did Include A Caveat That Provides Some Consolation To Republican Officials – In Washington And Boise – Who Want To Unwind Obamacare.”
“It is a victory for the rule of law, given how openly Idaho was defying the ACA. But the CMS letter did include a caveat that provides some consolation to Republicans officials — in Washington and in Boise — who want to unwind Obamacare. The state could conceivably tweak its proposal, Verma noted, to align with the Trump administration’s own proposed regulations to expand short-term insurance plans — which also do not have to comply with the ACA’s insurance regulations. It would be a back door to achieve the same end (providing an escape hatch from Obamacare for healthier customers, one that is likely to lead to higher premiums for those left behind in the law’s markets) and would be more clearly in line with the administration’s agenda.” [Vox, 3/8/18]