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What Will Obamacare Look Like In Idaho?

ObamacareLawmakers have spent the last several years preparing for the impending implementation of Obamacare in Idaho.  And preparing means “doing everything possible to shut it down” when you are Idahoan.  There’s not enough time to describe the measures being taken to prevent it, but suffice to say they are many and exhaustive.  There were in-excess of 30 US States that attempted to block the legislation from being enacted immediately after the President’s law was passed.  In the absence of anything concrete to counteract the law, many states have taken to creating laws at the state level that prevent the mandates of the federal law from being carried out.  That will unfortunately be more like trying to grab hold of a runaway rhinoceros; it accomplishes little and endangers everyone.

I did have the opportunity to listen to Mr. Tom Shores speak the other day at The Grotto Group in Meridian Idaho and he is the current sitting president of the National Association of Health Underwriters chapter for the State of Idaho.  He gave some very useful information about what “a day in the life” will be like for individuals and small businesses which undergo the transformation from their current insurance (or none at all) to offering the new plan.  Mr. Shores was appointed by Governor Butch Otter as one of only 12 people who sit on the board of directors for the State health exchange, created to establish the framework and functionality of that exchange and put the federal grant money to work for the citizens of Idaho.  Here are some tidbits of information that might be useful to you:

·         The State has until May 30th 2013 to have the Exchange in-place and fully functional with all plans from Idaho carriers approved. (those that qualify to be offered by the state) 

·         Then the exchange will begin allowing enrollment in the new plans effective October 1st of this year. 

·         Open enrollment is between October 1st 2013 and March 31st of 2014

·         There will be four plan tiers based on what kind of coverage you want:

                Platinum – Cost’s more monthly but offers lower deductibles and higher co-insurance.

                Gold – Offers a variety of deductibles and slightly lower co-insurance (say 70/30)

                Silver – Slightly higher deductibles to reduce cost, and less co-insurance (60/40

                Bronze – More of a major medical with higher deductibles and lower co-insurance.

Based on average household income, some 85% of all Idaho households will qualify for a “subsidy” of some kind.  The subsidy will be assessed based on your annual and monthly income and will be granted in proportion to your need based on family size and income. 

If you work for a company with 50 or more employers, your company is required by the new program to offer you one of the qualified plans offered by the State so long as you are considered full-time.  A full-time employee is now defined by 30 or more work hours in a week, or equivalent.  The equivalent part is an evaluation of your hours over a rolling period of time and as of right now I don’t know exactly what time-period that is.  Therefore if you work 40 hours this week and 20 hours next week you MAY qualify as full-time by the rules.  Those will be further defined in the near future.

If you do work for a company with 50 or more employees, and you are offered a plan, the total cost of the plan cannot exceed 9.5% of your W2 wages.   Therefore if you make $50,000 a year, your health insurance cannot cost more than approximately $395.84 per month with a very simplified illustration.

If your annual household income is in excess of $95,000 per year you probably will not be eligible for a subsidy to offset your health insurance premiums.

You ARE required by the law to purchase one of the qualified health insurance plans offered by the State.  If you choose not to purchase, you will be assessed an annual fee of $95 for refusing to purchase a plan.  If you are an employer and required to offer a plan to your employees, your company will be assessed a $2,000 per year penalty/fee for the failure to offer a qualified plan. (per employee minus 30)  So as you can see there are many people who are going to choose to pay the fee rather than purchase a plan.  And it will be interesting to see how the Government is going to be “collecting” this $95 fee from its citizens.  Probably through the IRS if they can get the support for it.

The next year, 5 years, and 10 years is going to be interesting case study in socialized medicine and the merits of a single-payer system.  Stay tuned here for future analysis, criticisms, and apologetics.  And if you want to get assistance with the purchasing of YOUR required health insurance plan, you can click here to apply for one of the existing plans, or get in touch with us so we can work together to put a new plan in place for you among the ones offered on the State Exchange starting in October.

Mark Nielebeck is the owner and proprietor of, LLC a Meridian Idaho Insurance Broker specializing in Auto Insurance, Homeowner’s Insurance, Business Insurance, and Health Insurance in the states of Idaho, California, and Oregon.  If you want to learn more about the changes which will take place in Idaho when the new healthcare laws go into effect, and would like to work with an advisor about how to put a new plan in place.  Contact BoiseInsure directly at the number below, or click any one of the links in this post that will lead you to the BoiseInsure web site.

Mark Nielebeck –, LLC (208) 340-2200

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