A study of Iowans and Nebraskans in 16 counties along the Missouri River finds a drastic difference in the prices being paid for health care through the federal program at www.healthcare.gov.
Jon Bailey directs the rural public policy program at the Center for Rural Affairs and he authored the survey. “We found that the premiums on average were lower in Iowa in those counties than in Nebraska,” Bailey says. “Really, the only major policy difference between the two states is the expansion of Medicaid. Iowa has done it, Nebraska has not.”
The study examined health exchange marketplace plans that are available in the counties along the Iowa-Nebraska border. He says it was surprising how the costs varied for what’s essentially the same service. Bailey says, “Depending on the level of plan that people bought, we found differences in the two states usually in the hundreds of dollars per year, some of them up to $600 per year less expensive in the Iowa counties than Nebraska.”
The counties studied included many of the same demographics in both states, from very rural farming counties to the metro areas of Omaha-Council Bluffs and Sioux City. “It’s interesting how a policy decision by one state affects what happens in that state compared to just a matter of miles across the river,” Bailey says. For the platinum level of coverage, Iowa border counties had higher average premiums, but Bailey notes the silver and gold plans under the Affordable Care Act are the most common by far, and they’re also the most important for low and middle-income families.
In the last two legislative sessions, he notes there were efforts to expand Nebraska’s Medicaid program, but filibusters kept the measure from getting to the floor for a vote. The Center for Rural Affairs is based in Lyons, Nebraska.