Idaho introduced a number of bills in the 2018 legislative session aimed at promoting price transparency and controlling healthcare costs. While most failed to pass, the legislature passed the Idaho Free Market Insurance Act (SB 1288), which allows individuals to lower their health insurance costs by making available competitive health plans from out-of-state insurance companies. The state also passed SB 339, which amends the Pharmacy Practice Act to enable lower cost substitution for prescription drugs that are in the same therapeutic class. In the 2016 legislative term, Idaho proposed but did not pass healthcare transparency legislation that would have required health insurers on the state’s ACA exchange to disclose a range of specific information.
The state currently has a ban on most favored nation clauses. A most favored nations clause is an agreement between a payer (such as an insurance company) and a provider that typically requires a provider to give the payer the lowest rate that it gives to any other comparable payer, which can be anticompetitive as it encourages oligopolistic pricing by large payers and increases barriers for new entrants.
Idaho has also been active in antitrust enforcement, as the Idaho Attorney General joined with the FTC to challenge the acquisition of Idaho’s largest independent, multi-specialty physician group by St. Luke’s Health System. In that case, the Ninth Circuit held that the acquisition violated Section 7 of the Clayton Act and the Idaho Competition Act.
The State Database
The Source tracks state activities impacting healthcare price and competition in both legislation and litigation in a searchable database to help stakeholders at the state level understand their legal and regulatory environment as they make efforts to improve access, quality, and efficiency, and reduce costs in healthcare. We currently cover bills from the 2017-2018 legislative term and key statutes from each state. Search the database for specific bills, statutes or cases by using keyword, key issue category, and/or jurisdiction.