BOISE — Most people insured through Idaho’s state exchange get federal tax credits to pay for it, raising all sorts of questions about what kind of coverage they will have and whether they will have insurance at all if the Affordable Care Act is repealed.
Eighty-seven percent of the 95,000 people covered through Your Health Idaho got tax credits to help pay their premium costs, for a total of $220 million a year in federal support, Executive Director Pat Kelly told the House Health and Welfare Committee Wednesday during a yearly report.
That’s $220 million a year the health plan would lose if President Barack Obama’s health care overhaul is repealed.
The average enrollee gets $257 a month in premium support, Your Health Idaho spokeswoman Karla Haun said.
“Any changes to the exchange will take time to understand and to implement, but we remain committed to ensuring Idahoans who rely on health coverage through Your Health Idaho experience minimum disruption,” Kelly said.
Kelly delivered this year’s report with uncertainty hanging over the future of the exchange. Congressional Republicans and soon-to-be-inaugurated President Donald Trump have vowed to dismantle Obama’s signature law, and replacement for “Obamacare” is unclear.
“What would happen if the Affordable Care Act is repealed and those tax credits went away?” asked Rep. Ilana Rubel, D-Boise. “Would they potentially lose their coverage under the exchange?”
Kelly said he is focusing on YHI’s day-to-day operations until he has a clearer idea of what will happen and what a replacement for the ACA might look like.
“I don’t have a crystal ball, but what I can tell you is we’re prepared to change,” he said.
If anything, Kelly said, he hopes Idaho’s exchange could become a model for an “Obamacare” replacement that could be extended to other states.
“The model that Idaho built can serve as a successful foundation for reforms,” he said. “The exchange is working for Idahoans.”
Open enrollment closes Jan. 31, and Kelly said he expects more than 100,000 people to be enrolled by the time it’s over. Kelly sang the praises of the exchange he runs on Wednesday, telling lawmakers it had “maintained its position as one of the leanest exchanges in the country.” It has also saved state and county taxpayers because more people with insurance led to a drop in indigent health care costs. Kelly said it has saved its enrollees more than $15 million since its creation over what they would pay on the federal marketplace, because the fee used to fund the operations of Idaho’s exchange is 1.99 percent of their plan’s cost rather than the 3.5 percent on the federal exchange.
“As a (state) exchange we’re nimble and we’re not hampered by federal bureaucracy,” he said.
The cost of the average plan went up steeply in many states last fall, including in Idaho, which saw jumps of 24 percent for the average individual plan and 4 percent for the average small group one. However, Kelly said, Your Health Idaho is offering more plans than it was before, in contrast with many states that have seen insurers fleeing exchange marketplaces.
Positive numbers such as the ones Kelly shared Wednesday have led many Idaho Republicans to praise Idaho’s exchange even though they oppose the federal law that led to its existence, a sentiment on display at Wednesday’s meeting.
“I never supported the Affordable Care Act,” said Committee Vice Chairwoman Rep. Kelley Packer, R-McCammon. “I knew there were components in it that were going to be very problematic for the health-care industry that was in crisis.”
Packer supported the exchange’s creation, a vote for which she said she has caught political flak since. She is also a Your Health Idaho board member.
“I’m excited to see that what happened was a success,” she said.
The U.S. House and Senate have already passed a resolution to take the first steps toward repealing parts of the law, although there is little agreement among Republicans in D.C. on how quickly to repeal it and what to replace it with. Repeal with no replacement would lead 18 million people to lose coverage, according to a report from the Congressional Budget Office this week, although congressional Republicans and Trump have said they do intend to replace it with something.