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‘Stopgap’ Plan Presented to Protect Iowans From ACA Provider Opt Outs

DES MOINES, Iowa -- The Iowa Insurance Division estimates 72,000 Iowans will be without access to insurance in 2018, but on Monday the division laid out a proposed plan to help those individuals. 

Over the past few months, major health care provider pillars of the Affordable Care Act have announced their intentions to drop out; this would leave more than 70,000 Iowans without health care options.

"It’s unacceptable that we don’t have a market, given the concentration of the insurance business we have in our state, it’s unacceptable to have an individual market that can’t function,” said Iowa Insurance Commissioner Doug Ommen.

At press conference on Monday, Ommen laid out his plan to make sure those Iowans are taken care of, but he emphasized this is not the solution.

“This is not a perfect plan. We’re attempting to, essentially, thread the needle between current structure of the ACA and making insurance available for 2018,” said Ommen.  

The exact details of the plan are still being fleshed out, but there are some preliminary details to note. One of noticeable change in this compared to the ACA is that young and healthy adults will get a little more of a subsidy or incentive to opt in, and older people will get slightly less. 

One item that won’t change is that health care providers will not be able to deny coverage based on a pre-existing condition. 

Finally Commissioner Ommen believes the cost will be slightly higher for most people, but he pointed out it’s better than the alternative options of having no insurance at all. 

“This is a stopgap measure, and there are long-term public policy decisions that need to be made in order to address that problem,” he said. 

This is not a done deal. The proposal will make its way to Baltimore and the Centers for Medicare and Medicaid Services for approval.

“They do want to get to a solution. I know that there are obstacles, this is an uphill climb, but I am optimistic that we will be able to provide some coverage for these individuals this year,” said Ommen. 

Ommen also said he has already started having discussions with providers and he’s optimistic they will be involved with this plan. Wellmark CEO John Forsyth has already publicly announced he supports this plan. Ommen expects to know more about the approval within the next 14 days.