Qualified Health Plans

In early January, Idaho Governor Butch Otter signed an executive order (EO) directing the state’s Department of Insurance (DOI) to “seek creative options” to expand “access” to health insurance coverage for Idahoans. The EO essentially deemed to allow health carriers in the state to offer plans on the health insurance exchanges created by the Affordable Care Act (ACA) “even if not all [ACA] requirements are met.”[1]  For many spectators, the most significant aspect about the order was not that it instructed a state agency to ignore federal law, but that it left open the question whether the Centers for Medicare & Medicaid Services (“CMS”), under the direction of Trump Administration appointee Seema Verma, would step in to enforce the ACA.  CMS’s response in early March was that it would enforce the ACA’s penalties against carriers that attempted to sell non-compliant plans, which was a rare instance of the Administration defending a law that it has otherwise attempted to eliminate. Continue Reading What Lessons Can We Take From The Administration’s Refusal to Allow Idaho to Dismantle the ACA Marketplaces?


The Patient Protection and Affordable Care Act calls for the establishment by 2014 of “American Health Benefit Exchanges,” the principle purpose of which is to provide eligible individuals and small businesses with access to affordable health insurance under “Qualified Health Plans.”  On August 14, 2012, HHS issued its final “Blueprint for Approval of Affordable State-based and State Partnership Insurance Exchanges” (the “Blueprint”). The Blueprint explains and facilitates the application process. It also directs HHS to determine whether the State will operate reinsurance and/or risk adjustment programs or will use Federal government services for these activities.

Mintz Levin’s Health Law Practice and Employee Benefits Practice have issued a joint Client Advisory, written by Gary E. Bacher and Alden J. Bianchi, regarding the Blueprint.