Iowa Insurance Commissioner proposes short-term fix for collapsing ACA market

Iowa’s insurance commissioner is asking the federal government to allow the state to implement a stopgap measure in its individual insurance market to ensure access to the nearly 72,000 Iowans relying on those health plans.

“The proposed Stopgap Measure is the only proposal ensuring that health insurance will be sold to those utilizing Iowa’s individual market in all of Iowa’s 99 counties in 2018. We are hopeful multiple carriers will participate to offer Iowans choices,” said Iowa Insurance Commissioner Doug Ommen in a news release. “Iowa needs CMS to approve the Proposed Stopgap Measure quickly. We are optimistic CMS will approve Iowa’s Stopgap Measure, but without CMS approval, 72,000 Iowans will be uninsured.”

In April, Wellmark Blue Cross and Blue Shield and Aetna announced they would stop selling individual health insurance plans on and off the Affordable Care Act exchange in Iowa in 2018, affecting nearly 58,000 people. Both insurers cited high costs and the uncertainty of the ACA’s future.

In May, Minnesota-based Medica — which sells plans in a majority of Iowa counties — hinted it may follow Wellmark and Aetna’s lead, but has not made an official or final decision yet.

The Stopgap Measure was designed in partnership with the Iowa Insurance Division, Wellmark Blue Cross and Blue Shield, and Medica. Ommen, along with Wellmark Chairman and CEO John Forsyth, and Medica Vice President Geoff Bartsch, discussed the Proposed Stopgap Measure with CMS last week in Washington, D.C.

The Insurance Division said that the proposed Stopgap Measure is the “only solution in which a health insurance carrier has committed to sell health insurance in every county of Iowa’s individual market.”

The proposed measure will provide consumers with age- and income-based tax credits and will use a reinsurance mechanism for costly medical claims.

“Wellmark is supportive of the proposed Stopgap Measure submitted to CMS because it includes the three principles we have continuously advocated for: creation of a viable risk pool, sharing catastrophic expenses and product flexibility,” Wellmark’s Forsyth said in the news release. “If the measure is approved in a timely manner with these principles intact, Wellmark will offer the approved individual health insurance plan in all 99 counties in Iowa for 2018,”

The health coverage sold under the Stopgap Measure to consumers during open enrollment of 2018 will be guaranteed issue, including all the Essential Health Benefits of the ACA and any additional benefits required by Iowa law, and will protect consumers from annual and lifetime caps. The Stopgap Measure is a short-term solution, but Iowa and many other states need a long-term fix from Congress to stabilize the damage done by the ACA, the insurance division said.

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