The Iowa Insurance Commissioner is proposing what he calls a stopgap measure to ensure Iowans have access to health insurance in 2018, after all of the major providers of individual plans have pulled our or are considering pulling out.
Insurance Commissioner Doug Ommen says they hope this plan will give people access to an individual insurance plan in all 99 counties.
“The effort that we’ve made involves several carriers that have come forward to work with us in order to put together a proposal that we believe will serve the need of the individuals in our state that rely on that individual market,” Ommen says. Wellmark Blue Cross and Blue Shield and Aetna announced they would stop selling individual health insurance because of the high cost under the federal Affordable Care Act — and the final carrier — Medica says it is also considering pulling out. Ommen says that’s what’s driving the proposed stopgap.
“Medica has made it clear to us as well in their public statements that if nothing changes that they don’t see how they would be able to provide coverage for Iowans. I think that they are still considering all of their options,” according to Ommen. “But we have been consulting with them in this proposal, and believe that they along with Wellmark would be able to participate and provide coverage.” He says the governor asked him to look at some sort of solution to fix the problem and this is it.
“I believe we have reviewed every possibility and view that this is the only option in order to establish an individual commercial market,” Ommen says. The plan would take the money currently available under Obamacare and would offer and income-based tax credits for people to get insurance. He says it addresses the problem with the current system where young people are dropping out.
“What we are proposing is a redirection of subsidies to be based both on age as well as a modified income-based program. It also sets up a reinsurance mechanism to address some of the concentration of individuals in our market with persistent health conditions,” Ommen says. He was asked about the prospects for the plan being given the green light.
“It does involve federal approval — so you would have to direct that question to the federal authorities. We are optimistic that there is an interest certainly under the administration to get to a solution,” he says. Ommen says it adjusts the way the money is distributed.
“Under the current ACA, most of the subsidy comes in the form of those advanced premium tax credits which are administered through the IRS,” Ommen explains. “What we are asking for in our proposal is a redirection of those subsidies on a per-member, per-month basis.” He says Iowa’s problems aren’t unique when compared to other states.
” I think our market is in crisis across the country. What will vary will be the number of carriers that are in a state who may be servicing different parts of the state, and therefore the individual company’s financial losses may not be so concentrated,” Ommen says. “You know we started out with a number of carriers several years ago, and as that number has declined — it is concentrating the losses.”
Ommen says they will be talking with the Centers for Medicare & Medicaid Services and hope to have some idea within the next 14 days or so if the stopgap will be approved.