Since Donald Trump was elected president, the Republican Party has repeatedly attempted to repeal the Affordable Care Act, only to see its replacement bills voted down in Congress amid scores of demonstrations. Now one red-state government is taking matters into its own hands—by ignoring the legislation's requirements and defying the rule of law.
According to the Wall Street Journal, Idaho will allow insurers to offer state-based plans whose premiums are determined by their clients' medical histories, a practice known as underwriting that is prohibited under Obamacare. Health insurance providers can separately buck the ACA by placing caps on the amounts they pay out in benefits.
“I don’t see how this is reconciled with the basic ACA requirements,” Scott E. Harrington, a healthcare management professor at the University of Pennsylvania’s Wharton School, told the Journal. Larry Kaiser of the nonprofit Kaiser Family Foundation called the state's latest gambit a "Wild West strategy."
Blue Cross of Idaho does not appear to share his concern. While chief executive Charlene Maher acknowledges the health insurance provider is reviewing the state's new guidelines, she has praised officials for "[providing] uninsured middle-class families in Idaho with choices in health insurance at a price that fits their budget and meets their needs." (Idaho is one of 18 states that has refused to expand Medicaid coverage under the ACA.)
The question now is what action the federal government plans to take, if any. Alex Azar, a former pharmaceutical industry executive and Trump's newly appointed secretary of Health and Human Services, has not only been a vocal critic of the Affordable Care Act but "is expected to play a central role in Trump administration efforts to roll back the federal health law," per the Journal.
Last month, Trump boasted that he had effectively repealed Obamacare through the passage of the Tax Cuts and Jobs Act, which eliminates the bill's individual mandate that Americans purchase insurance or face a tax penalty. But the legislation, as well as its restrictions, remain the law of the land.