States findings of the Legislature, supports certain Department of Insurance efforts, and requests federal guidance.

LEGISLATURE OF THE STATE OF IDAHO Sixty-eighth Legislature Second Regular Session - 2026 IN THE HOUSE OF REPRESENTATIVES HOUSE JOINT MEMORIAL NO. 16 BY HEALTH AND WELFARE COMMITTEE A JOINT MEMORIAL1 TO THE ADMINISTRATOR OF THE CENTERS FOR MEDICARE AND MEDICAID SERVICES, TO2 THE SENATE AND THE HOUSE OF REPRESENTATIVES OF THE UNITED STATES IN CON-3 GRESS ASSEMBLED, AND TO THE CONGRESSIONAL DELEGATION REPRESENTING THE4 STATE OF IDAHO IN THE CONGRESS OF THE UNITED STATES.5 We, your Memorialists, the House of Representatives and the Sen-6 ate of the State of Idaho assembled in the Second Regular Session of the7 Sixty-eighth Idaho Legislature, do hereby respectfully represent that:8 WHEREAS, Idaho seniors and other Medicare beneficiaries rely on ac-9 cess to affordable Medicare and prescription drug coverage that meets their10 health care needs; and11 WHEREAS, federal law provides a limited annual enrollment period during12 which Medicare beneficiaries must select health coverage options for the up-13 coming plan year; and14 WHEREAS, the Centers for Medicare and Medicaid Services (CMS) oversees15 Medicare Advantage plans, including plan approval, bid review, and federal16 program requirements; and17 WHEREAS, the Idaho Department of Insurance regulates insurer licen-18 sure, solvency, and market conduct within the State of Idaho, including19 Medicare Supplement products and insurance producer activity; and20 WHEREAS, effective Medicare oversight relies on clear coordination be-21 tween federal regulators and state insurance regulators; and22 WHEREAS, CMS and the Idaho Department of Insurance maintain a memoran-23 dum of understanding allowing cooperation and information sharing regarding24 violations of applicable laws, rules, and guidance; and25 WHEREAS, maintaining stability and predictability in Medicare Advan-26 tage plan availability is essential to protecting Medicare beneficiaries27 during the annual enrollment period; and28 WHEREAS, Medicare beneficiaries have limited time during the annual en-29 rollment period to make informed decisions regarding their health care cov-30 erage options; and31 WHEREAS, Medicare beneficiaries often rely on licensed insurance pro-32 ducers to assist with plan selection, and sudden changes to producer compen-33 sation structures may reduce consumer access to informed guidance during the34 annual enrollment period; and35 WHEREAS, insurers seeking to offer Medicare Advantage plans in Idaho36 must submit bids to CMS and receive approval to offer plans while complying37 with applicable federal and state requirements; and38 WHEREAS, insurance companies are required to actuarially develop their39 rates using appropriate justification; and40 WHEREAS, sudden limitations, withdrawal of plan availability, or mar-41 ket conduct that discourages enrollment during the annual enrollment period42

2 may disrupt consumer choice and market stability for Medicare beneficia-1 ries; and2 WHEREAS, before the 2025 open enrollment period, certain companies,3 after actuarially pricing, voluntarily applying for, and being awarded the4 Medicare contract, attempted to dissuade or steer consumers away from their5 products; and6 WHEREAS, certain companies withdrew their enrollment applications, de-7 nied access to Idaho seniors and those who qualify for Medicare, and created8 market disruption; and9 WHEREAS, the Idaho Department of Insurance issued a bulletin identify-10 ing these practices as unfair trade practices under Idaho law; and11 WHEREAS, due to some companies continuing to operate in a harmful manner12 to Idaho seniors, Medicare recipients, and to the Medicare market, the Idaho13 Department of Insurance issued cease and desist orders; and14 WHEREAS, it is the public policy of the State of Idaho that insurers op-15 erating within the state comply with all applicable laws governing licen-16 sure, solvency, and trade practices, and that Medicare beneficiaries have17 meaningful access to approved coverage options; and18 WHEREAS, it is further the public policy of the State of Idaho that in-19 surance companies who apply to offer coverage should not engage in practices20 that discourage enrollment or limit plan availability after approval to of-21 fer such coverage.22 NOW, THEREFORE, BE IT RESOLVED by the members of the Second Regular Ses-23 sion of the Sixty-eighth Idaho Legislature, the House of Representatives and24 the Senate concurring therein, that the Idaho Legislature supports the on-25 going efforts of the Idaho Department of Insurance to protect Idaho Medicare26 beneficiaries and promote a stable and fair insurance marketplace.27 BE IT FURTHER RESOLVED that the Legislature encourages the Idaho De-28 partment of Insurance to continue working with CMS to ensure Idaho Medicare29 beneficiaries are protected against unfair or disruptive market practices.30 BE IT FURTHER RESOLVED that the Legislature requests CMS to continue31 collaboration with Idaho and other state insurance regulators and to pro-32 vide clear guidance regarding federal and state oversight responsibilities33 related to Medicare Advantage plans.34 BE IT FURTHER RESOLVED that the Legislature requests CMS to provide35 guidance regarding changes to producer compensation structures after plan36 approval and its impact on consumer access and market stability.37 BE IT FURTHER RESOLVED that the Chief Clerk of the House of Represen-38 tatives be, and she is hereby authorized and directed to forward a copy of39 this Memorial to the Administrator of the Centers for Medicare and Medic-40 aid Services, to the President of the Senate and the Speaker of the House of41 Representatives of the United States in Congress assembled, and to the con-42 gressional delegation representing the State of Idaho in the Congress of the43 United States.44