What does “substantially” mean?

That could be the pivotal question for Idaho, whose chief executives now must justify their plan to let Idahoans buy health insurance in defiance of the Affordable Care Act.

Gov. Butch Otter, Lt. Gov. Brad Little and Idaho Department of Insurance Director Dean Cameron said earlier this year that insurers would be allowed to sell plans that don’t comply with the ACA, also known as Obamacare. They called the plans “state-based” insurance.

Those state officials — relying on legal opinions including those written by lawyers for Blue Cross of Idaho — believe they are “substantially enforcing” the law.

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Promising to build on the Affordable Care Act, a coalition of influential interest groups announced a new legislative push Thursday for a patchwork of measures that aim to make healthcare in California cheaper and more accessible.

Advocates touted a slate of proposals, including expanding Medi-Cal access to adults without legal status and increasing subsidies to those buying insurance on the Covered California exchange, as priorities for this legislative session.

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Sens. Lamar Alexander and Susan Collins have proposed a market stabilization package that would include funding for the Affordable Care Act’s cost-sharing reduction subsidies for three years, three years of federal reinsurance at $10 billion a year, additional ACA waiver flexibility for states, and expanded eligibility for “copper” plans.

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The tax-reform provision repealing the penalty on those who refuse to participate in ObamaCare has freed millions of Americans to escape a system that exploits them. But while Americans can escape ObamaCare, they still can’t buy insurance in the individual market independent of ObamaCare because private insurers are prohibited from selling it. If this prohibition can be removed through the granting of state waivers by the Department of Health and Human Services, or by the passage of a new federal statute, ObamaCare will collapse into a high-risk insurance pool for the seriously ill rather than become a stepping stone to socialized medicine.

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Both Democrats and Republicans in Washington are considering policies that would not only retain ObamaCare for the indefinite future, but also expand this health-care disaster beyond even President Obama’s ambitions. These proposals would snatch defeat from the jaws of victory by shoveling billions of additional dollars in deficit spending into the pockets of insurance companies, which have been losing money on ObamaCare’s exchanges because of the law’s misguided one-size-fits-all approach. The real solution is obvious: we need to do away with this massive, expensive and unfair government program, instead of throwing money at a handful of corporations to tolerate it. But few have accused Washington of ever recognizing the obvious.

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