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Democratic Health Leaders Demand Explanation on Idaho’s Illegal Junk Plans

February 23, 2018

Members question Idaho Department of Insurance on move to allow plans that ignore federal law and consumer protections; Proposed plans would illegally charge higher premiums for older and sicker patients

WASHINGTON, DC – Yesterday, Congressman Richard Neal (D-MA), Ranking Member of the House Committee on Ways and Means, Senator Patty Murray (D-WA), Ranking Member of the Senate Health, Education, Labor, and Pensions (HELP) Committee, Senator Ron Wyden (D-OR), Ranking Member of the Senate Finance Committee, and Congressman Frank Pallone Jr. (D-NJ), and Ranking Member of the House Committee on Energy and Commerce sent a letter to Dean Cameron, Director of the Idaho Department of Insurance, questioning the Department's bulletin permitting plans which flout federal law and fail to provide required consumer protections.

"Last month, the Idaho Department of Insurance issued a bulletin permitting the sale of "state-based plans" that do not satisfy consumer protections required of individual market insurance coverage under federal law. We request an explanation of how the Idaho Department of Insurance plans to regulate insurance plans being sold in the individual market that are not compliant with federal law," wrote the four Democratic health leaders. "We strongly oppose efforts that result in higher costs and undermine consumer protections that are guaranteed in Federal law that protect women, people with pre-existing conditions, and others facing discrimination in access to health care… The proposed plans would charge higher premiums for older and sicker patients in ways that are prohibited under federal law, which permits variation in premiums based only on family size, geography, age, and tobacco use. Blue Cross of Idaho's application for these "state-based plans" seeks information about a potential enrollee's medical history, ranging from reproductive health conditions to a history of mental illness and substance use, and the insurer would be permitted to charge enrollees more based on their responses. The plans can deny coverage for those with pre-existing conditions who have not had continuous coverage. The plans would also include annual limits on coverage, and at least one plan would not cover critical essential health benefits like maternity care."

The Members also released the response they received to a previous letter on this issue they sent to Health and Human Services (HHS) Secretary Alex Azar and Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma. In that letter, the Members expressed their concern about the potential for Idaho plans to skirt federal law and requested information about what legal justifications for Idaho's decision were considered.

A PDF of the letter can be found HERE.

The previous letter the Members sent to HHS and CMS on January 31st, 2018 to express their concern and request information can be found HERE, and the response from CMS to that letter can be found HERE.

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