Understand what the Freedom Blue plans are and why they’re important in the midst of health-care reform.
Keeping up with healthcare reform can seem like a never-ending rollercoaster ride—one day headlines seem to suggest the Affordable Care Act (ACA) is hanging by a string, and the next day it may seem that almost nothing has changed from the ACA’s health-care original road map. You might want to check out eHealth’s Trumpcare Updates page, to stay up-to-date.
One important development in the health-care world you may want to be aware of: there are five new individual health insurance plans (called Freedom Blue plans) available from Blue Cross of Idaho, a not-for-profit health insurance company.
What’s so important about the Freedom Blue plans in Idaho?
With all the individual health insurance plans out there, why does it matter that some insurance company in Idaho has come up with a few more? The issue is that these are some of the first plans, since the ACA came into being, that are not compliant with all of its laws.
These Freedom Blue PPO plans exist because of an executive order signed by Idaho’s governor, C.L. Otter. In early February of 2018, he and fellow Idaho regulators decided to allow the sale of individual and family health insurance plans that do not meet ACA standards. The order loosens ACA rules, and encourages the Department of Insurance (DOI) to be flexible with their guidelines for Idaho insurers to offer plans at lower prices, even if it means skimpier benefits than what the ACA has allowed in the past.
Remember, the Affordable Care Act (ACA) is still in effect
You’ve probably heard that the ACA’s “individual mandate” provision was repealed in late 2017. That means that Americans are no longer required to get health care that meet the ACA’s standards after 2018. Also, the federal government may no longer support funding for the Cost Sharing Reductions Program (CRSs), but these changes in the American health-care system don’t mean that the Affordable Care Act itself has been repealed.
Yet, the Freedom Blue plans do not abide by federal law (the ACA). They do not meet minimum essential coverage standards, and applicants with pre-existing conditions could pay higher premiums on these plans. Read on to see more details about the Freedom Blue plans in Idaho.
What do the Freedom Blue plans offer in terms of health coverage?
Since its beginning, the ACA required health insurance plans to cover ten essential benefits, which you can see below. By offering select benefits, Blue Cross of Idaho’s health insurance plans proposes to help middle-class Americans who cannot afford Obamacare.
Blue Cross of Idaho’s Freedom Blue plans were directed at middle-class Americans who have felt that the current marketplace is not affordable for them (especially if they make more than 400% of the federal poverty level and don’t qualify for Obamacare subsidies). These plans are designed to help meet the needs of the estimated 110,000 middle-class uninsured Idahoans, according to Blue Cross of Idaho’s website.
Here are some of the key differences between ACA-compliant plans and the Freedom Blue plans from Blue Cross Idaho:
- Pre-existing conditions might matter. A huge difference with these Freedom Blue plans is that they can determine premiums based on your health. One of the ACA’s hallmark characteristics was that it banned discrimination based on pre-existing conditions. This meant that no matter how healthy you were, you would be paying the same amount as someone who has medical issues and may cost the health insurance company more money. But with these affordable Freedom Blue PPO plans, individuals and families will be assessed on prior health records.
- Premiums lean heavily in favor of young, healthy people. Premiums on these plans vary widely; a young person generally pays a great deal less than a senior under the same plan. Obviously, this is a better deal for the young person, who could be paying 50% more for an ACA-qualified plan.
- Deductibles and out-of-pocket limits may be high. Because these plans aim to make health insurance affordable, they offer low premiums, but high costs elsewhere. The American Journal of Managed Care reports that Freedom Blue deductibles can be thousands of dollars and may have an annual $1 million per-person limit. Overall, these plans offer less coverage than ACA plans.
- One of the plans (out of five) will not cover maternity. With Obamacare plans, maternity care was a minimum essential benefit. Four out of the five Freedom Blue plans still do cover maternity care.
- The plans do not cover include pediatric or vision coverage. Those benefits were minimum essential coverage under Obamacare, but Freedom Blue plans don’t include them. The plans do cover hospitalization, emergency care, and mental health treatment though.
As outlined on Highmark Blue Shield’s explanation of Freedom Blue PPO benefits, these plans are offered in the following counties in Idaho. Please note that Blue Cross Idaho might change this information after this article is published.
Can people in these counties still get Obamacare-compliant individual and family health insurance plans?
According to Blue Cross of Idaho, ACA-compliant plans will still be available from Your Health Idaho (Idaho’s state exchange). The new non-ACA state-based plans seek out to help middle-class Americans, but still leave open marketplace options that have worked for people prior to the governor’s executive order.
Although the insurance company has released these plans, legal challenges could still arise from Idaho’s move to create their own state-based health insurance that defies federal law. This article is for general information and may not be updated after publication. Consult your own tax, accounting, or legal advisor instead of relying on this article as tax, accounting, or legal advice.