Iowa ACA marketplace hangs by thread as last major insurer threatens exit

Most counties in Iowa could have no insurers selling plans on the state's 2018 ACA health insurance exchanges, reports The Washington Post.

Here are five things to know.

1. Minnetonka, Minn.-based Medica has threatened to leave the state's marketplace in 2018 amid political uncertainty, according to the report. The report cites a statement from Wednesday in which Medica said its continued participation "is in question."

2. Medica is the third-largest insurer in Iowa's ACA marketplace, with more than 12,600 members through the marketplace statewide, according to the report.

3. Geoff Bartsh, a vice president at Medica, told The Washington Post no final decisions have been made regarding the insurer's potential exit, and it will remain that way until June 19, Iowa's deadline to submit premium rates.

4. According to the report, Medica was already thinking about scaling back its participation in Iowa's marketplace, before its two major competitors in the state — Hartford, Conn.-based Aetna and Des Moines, Iowa-based Wellmark Blue Cross and Blue Shield — declared they will exit Iowa's ACA exchange in 2018.

"The absence of any competition or any of the other carriers accelerated the decision that we won't be statewide," Mr. Bartsh told The Washington Post. "For us, as a small carrier in Iowa, the unknown risks far outweigh the known risks. Our ability to offer products statewide knowing we'd be the only option for the 70,000 individuals in this market are just too great."

5. Gunderson Health Plan, a subsidiary of La Cross, Wis.-based Gundersen Health System, would be the only insurer left in Iowa's marketplace if Medica leaves, according tot the report. Gunderson Health Plan currently only offer plans in five counties in Iowa.

Read the full report here.

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