Trump’s HHS Draws Red Line, Says Idaho Can’t Openly Flout Obamacare

Andrew Harnik/AP

Since coming into power last year, the Trump administration has worked to undermine and chip away at the Affordable Care Act, repealing some key provisions and encouraging states to push the envelope on cutting back their Medicaid expansions under Obamacare. But in a letter to Idaho on Thursday, CMS Administrator Seema Verma drew a red line, saying the state cannot move forward with its plan to defy the remaining provisions of the Affordable Care Act.

“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 wrote. “However, the Affordable Care Act remains the law, and based on our review of Idaho Bulletin No. 18-01, CMS has reason to believe that Idaho would be failing to substantially enforce the provisions.”

Had the Department of Health and Human Services not intervened, Idaho would have allowed insurance companies in the state to sell plans that violate Obamacare’s rules—plans that, for example, have lifetime limits, don’t cover pre-existing conditions, exclude mental health care or charge patients more based on their age or health status. The cheaper, skimpier plans were expected to lure thousands of Idahoans out of Obamacare’s regulated individual market, spiking premiums for those who remained.

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.

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