Medica Remains Last Iowa Obamacare Exchange Insurer

AURORA, CO - MARCH 27: A medical assistant checks a patient's blood pressure at a community health center on March 27, 2012 in Aurora, Colorado. The center, called the Metro Community Provider Network, has received some 6,000 more Medicaid eligable patients since the healthcare reform law was passed in 2010. …
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Medica will remain the last Iowa Obamacare exchange insurer, although it will sell its health plans at much higher premiums.

Medica explained that to remain in the Iowa Obamacare exchange market, it will have to raise premiums by an average of 43 percent. Iowans who receive Obamacare subsidies might shield consumers from the cost, but those who do not receive the subsidies will feel the brunt of the hike in premiums.

Insurers had to file their proposed rates for health policies in Iowa on Monday. Medica was the only health insurance company to file. Wellmark and Aetna, the other two major insurers, announced that they will not sell health insurance in Iowa next year.

Wellmark’s chief executive, John Forsyth, wrote in an op-ed of the changes that Iowa would have to make for the company to sell insurance in the state. Iowa officials have petitioned the Centers for Medicare & Medicaid Services (CMS) Seema Verma for waivers that would allow the state to bend Obamacare regulations and allow insurers to sell more flexible and affordable health plans.

Iowa Insurance Commissioner Doug Ommen announced Monday he will continue with his state’s petition to the federal government, which would allow crucial changes to salvage the state’s insurance markets.

Ommen explained in a statement, “We appreciate and understand Medica’s desire to provide coverage in all of Iowa’s 99 counties. That is our goal as well.”

“We are concerned that Iowa has hit a point within our market’s collapse that a 43% rate increase will drive healthier, younger, and middle aged individuals out of the market. Iowa’s individual market remains unsustainable and needs a fix from Congress. Iowa will continue to move forward with the proposed stopgap measure.”

The Iowa Republican proposal would trim down the Obamacare insurance plans to one plan similar to the Affordable Health Care Act’s (ACA) “silver” level plan, balancing cost and coverage. Iowa would tie Obamacare subsidies for lower-income Americans to purchase health insurance to age and income, similar to the Senate’s healthcare bill.

Individual health insurance consumers could also purchase plans created outside of the state’s Obamacare exchange. The new Iowa proposal mandates that individual insurance consumers must maintain coverage throughout the year and cannot miss a gap of insurance coverage longer than 63 days.

The proposal would also retain Obamacare’s essential health benefits and implement a reinsurance program to limit the cost of health insurers’ most expensive enrollees.

Medica Vice President Geoff Bartsh said in a statement, “When you find yourself as the only ones between people getting access to care and people not getting access to care, your view of the situation becomes very different.

“We’ve filed with the intent to provide access to insurance for all Iowans, whether they are farmers, small business owners or other individuals who need coverage.”


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