87,000 Idahoans could lose health insurance

Jan. 19--BOISE -- As many as 87,000 Idahoans could lose health insurance coverage if the Affordable Care Act is repealed before a replacement plan is ready, a House panel learned Wednesday.

Pat Kelly, executive director of the Your Health Idaho state insurance exchange, told the House Health and Welfare Committee that 100,000 Idahoans have signed up for health insurance during the current enrollment period, which ends Jan. 31.

Historically, 87 percent of those who buy insurance through the exchange qualify for federal tax credits, he said. The subsidies -- which last year totaled $220 million -- help lower monthly premiums to a level most people can afford.

So if Congress repeals Obamacare without having an alternative in place, "does that mean 87 percent would lose their insurance?" asked Rep. Ilana Rubel, D-Boise.

"In the event the tax credits cease to exist, 87 percent would no longer receive monthly premium assistance," Kelly replied.

Given the discussions taking place in Congress right now, Rubel said Idahoans "need to understand what a straight repeal" of the Affordable Care Act might look like.

"There's a movement to just repeal it (and not replace it)," Rubel said after the meeting. "I think the state exchange is an unqualified success, but it's built on a foundation of ACA subsidies. Without that $220 million, the entire exchange could crater" because people wouldn't be able to afford insurance.

Kelly declined to speculate about the fate of Your Health Idaho in the event Congress repeals the ACA.

"Until there's more clarity, we'll focus on our day-to-day operation," he said.

However, Kelly noted that Your Health Idaho is one of the most affordable exchanges in the nation. Its 1.99 percent operating fee, assessed on the cost of each policy sold through the exchange, is almost half the rate charged in states that rely on the federal exchange.

That difference alone has saved Idaho consumers an estimated $15 million in fees, Kelly said. In addition, the Catastrophic Health Fund returned nearly $29 million to the state general fund last year, largely because increases in insurance coverage have reduced indigent care costs.

Your Health Idaho also has the second-highest per capita enrollment rate in the country, Kelly said, and it entered the year with a record 211 plans to choose from.

"We've proven to be nimble and our technology is flexible, so we can envision how to serve a private insurance market (in a post-Obamacare world)," he said.

House Majority Caucus Chairman John Vander Woude, R-Nampa, agreed that the Idaho exchange is a success, "but whether that's the vehicle Idaho wants to use to get insurance to people is a different ball game."

Vander Woude objects to the Affordable Care Act in part because it typically requires people to purchase health insurance within a limited, two-month window. It also mandates a long list of benefits, including maternity and birth control services for people who may not need or want them.

He also thinks Rubel's concerns about a straight repeal of Obamacare, without a replacement, are unrealistic.

"That's not going to happen," Vander Woude said. "There's going to be something to replace it."

Rubel disagreed, noting that "no one in the country has seen a replacement plan yet."

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Spence may be contacted at bspence@lmtribune.com or (208) 791-9168.

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