Adds to existing law to provide that the Director of the Department of Insurance shall permit health benefit plans that are not ACA compliant, to provide a direct primary care program for Medicaid participants, and to provide that the State Department of Health and Welfare shall seek certain waivers or amendments to waivers.

The federal government has stringent requirements that make it difficult for Idahoans to buy affordable health insurance coverage. This legislation codifies the Governor's Executive Order to allow Idahoans to purchase non-ACA plans that are compliant with state requirements. The new statute would provide flexibility from individual and small employer insurance plans requirement for essential health care benefits, state community and age ratings, and actuarial value regulations. Idaho insurance companies would be able to offer less-expensive, tailored insurance plans. It would also allow Idaho to apply for a 1332 State Innovation Waiver, only if the federal government requires a waiver for Idaho to sell non-ACA plans. This legislation would also allow the state to make improvements to the Medicaid program via a second, 1115 Medicaid Waiver. This waiver would allow the state to establish a direct care program, impose work requirements for able bodied adults without children, and impose lifetime limits with clear exemptions for pregnant women, caregivers, etc. It should be noted that the Centers for Medicare and Medicaid Services is not approving waivers that do not have legislative authorization. Therefore, the waivers that are drafted will need to be brought back to the legislature during the 2019 session.