Today, Blue Cross of Idaho announced that it will follow Republican Governor Butch Otter’s lead and violate federal law by offering insurance plans that don’t conform to the consumer protections mandated by the Affordable Care Act. Blue Cross of Idaho is leading the charge to take people back to a time when insurance companies could decide whether they were taken care of when they got sick, and it’s now incumbent upon the Trump Administration, specifically Health and Human Services Secretary Alex Azar, to uphold the law of the land – just as he swore to do upon assuming his Cabinet position. How is this announcement being treated so far?

American Cancer Society Cancer Action Network, American Diabetes Association, American Heart Association, American Liver Foundation, American Lung Association, Cystic Fibrosis Foundation, Epilepsy Foundation, Hemophilia Federation of America, Leukemia & Lymphoma Society, Lutheran Services in America, March of Dimes, Mended Little Hearts, Muscular Dystrophy Association, National MS Society, National Organization for Rare Disorders: “The Federal Government Must Uphold The Requirements Of Federal Law.” “Idaho’s insurance bulletin would allow insurers to sell individual market plans that do not comply with federal law. Because the Idaho Bulletin purports to authorize the issuance of insurance coverage that is prohibited by federal law, it is legally invalid… The federal government must uphold the requirements of federal law that protect patients, their families, and the health system against these consequences. On behalf of our patients, and all Americans, we urge you to make clear that Idaho cannot authorize the issuance of health insurance coverage that violates federal law, and that any insurer that issues such plans risks enforcement action and serious penalties.” [ACS-CAN, 2/14/18]

Los Angeles Times: “Not A Good Sign For The Rule Of Law.” “If he is serious about his duty to uphold the Affordable Care Act, Azar has no real option other than to nip the Idaho venture in the bud. He could have taken a strong stand during his appearance on Capitol Hill Wednesday, but failed. That’s not a good sign for the rule of law.” [LA Times, 2/14/18]

Business Insider: “HHS Is Required By The ACA To Step In And Take Over Regulation Of Any State That Does Not Meet Regulatory Standards.” “Blue Cross of Idaho announced Wednesday it would take advantage of the state’s new loophole for Affordable Care Act regulations, prompting questions over how the Trump administration will respond… HHS is required by the ACA to step in and take over regulation of any state that does not meet regulatory standards, and the department has done so in four states already.” [Business Insider, 2/14/18]

The Hill: The Proposed Plans Contain Features “Not Allowed.” “[The] proposal is legally questionable and has drawn backlash from Democrats who say he is simply ignoring federal law. The [plans] would charge people with pre-existing conditions more and have a limit of $1 million in claims per year, according to the Idaho Statesman. Both of those features are not allowed under ObamaCare… Democrats have been pressuring Secretary of Health and Human Services Alex Azar to step in to stop Idaho’s plan and enforce the law.” [The Hill, 2/14/18]

Washington Examiner: Proposed Plans “Put Pressure On The Federal Government To Step In And Enforce Rules.” “Many experts have questioned whether this would survive a legal challenge, because Obamacare requires plans sold on the law’s insurance marketplaces, which offer coverage on the individual market, to meet certain benefit requirements… Idaho’s action has put pressure on the federal government to step in and enforce rules that the Trump administration has pushed to repeal.” [Washington Examiner, 2/14/18]

Bloomberg: Proposed Policies “Are Specifically Forbidden.” “[The policies proposed] are specifically forbidden by the 2010 law. The move sets up a potential conflict with the federal government. While President Donald Trump has said he opposes the law and has taken steps to undermine it, the administration will have to decide whether to enforce legal requirements that remain on the books.” [Bloomberg, 2/14/18]

Washington Times: The Trump Administration “Is Responsible For Enforcing [The Law].” “The Idaho situation is a key test for the Trump administration, which still wants to repeal and replace Obamacare but is responsible for enforcing the 2010 law while it remains on the books… Obamacare’s defenders say the Idaho plan skirts the law completely, however, so HHS must act to preserve hard-won consumer protections. ‘It’s cruel, and it’s an illegal attempt to repeal our health care,’ Save My Care, a pro-Obamacare coalition, says in new ads running in Boise, Idaho, and the nation’s capital. ‘Call Health and Human Services Secretary Alex Azar. Tell him to block Governor Otter’s attack on our health care.’” [Washington Times, 2/14/18]

As a reminder, here’s what legal experts are saying about Idaho:

Tim Jost, Washington and Lee University School of Law Emeritus Professor: “What They’re Doing Is Completely Illegal.” “Both in terms of federal penalties and in terms of potential private lawsuits, they are taking on tremendous liabilities here. What they’re doing is completely illegal. It’s kind of jaw-dropping.” [Bloomberg, 2/14/18]

Larry Levitt, Kaiser Family Foundation Senior Vice President: “This Is Simply Not Allowed.” “Idaho is allowing health insurance plans that charge sick people more than healthy people, have an annual limit on coverage, and don’t cover maternity care. That’s simply not allowed under the ACA. If a state like Idaho is not enforcing the ACA’s insurance protections, the federal government is obligated to step in and enforce the rules…. If HHS does not step in and enforce the ACA’s insurance rules in Idaho, it won’t just be about Idaho. Other conservative states will no doubt then start to allow insurance plans that don’t comply with the ACA.” [Twitter, 2/14/18]

Will Secretary Azar follow the oath he swore to uphold just weeks ago? Or will he allow states to violate the very laws he pledged to uphold?