Idaho public health officials enacted a provision quietly on Monday that allows hospitals in the northern part of the state to withhold lifesaving care to some patients suffering from coronavirus to direct those resources to other patients, the Associated Press reports.

A deep-red state, Idaho decided to ration care because the rural hospitals in the area are close to full and the providers don’t have the facilities to treat all patients.  The move, which comes more than 11 years after the United States passed the Affordable Care Act and which is independent of the ACA even through Republicans said it would have government rationing health care, is known as the “crisis standard of care” and allows medical professionals to triage patient need.

The ruling impacts 10 hospitals and medical care groups in the panhandle of Idaho and northcentral counties.  With the rule, doctors can determine if a patient merits the usage of life saving equipment over another patient.  The rule also allows hospitals to put patients in various rooms in the hospital such as conference room and classrooms that would not meet state standards as a medical care bed. 

The state’s Crisis Standards of Care Activation Advisory Committee determined Monday that hospitals in the state have exhausted all options to expand care.  This allowed Idaho Department of Health and Welfare Director Dave Jeppesen to enact the crisis standards, which he did at 5 p.m. local time.

“Crisis standards of care is a last resort. It means we have exhausted our resources to the point that our healthcare systems are unable to provide the treatment and care we expect,” Jeppesen said in a statement.  “This is a decision I was fervently hoping to avoid. The best tools we have to turn this around is for more people to get vaccinated and to wear masks indoors and in outdoor crowded public places. Please choose to get vaccinated as soon as possible – it is your very best protection against being hospitalized from COVID-19.”