Following Hartford, Conn.-based Aetna‘s and Des Moines, Iowa-based Wellmark Blue Cross and Blue Shield’s exit from the 2018 exchange in April, 94 out of 99 counties in Iowa will have one insurer selling individual plans on the exchange. State officials assert extensive and quick change is the only means to “avoid a total collapse of Iowa’s individual health insurance market.”
Here are seven things to know about the proposal.
1. Dubbed the “Stopgap Measure,” the proposal would eliminate Iowa’s ACA exchange and provide federal assistance to eligible individuals buying health coverage off the exchange, The Washington Post reports.
2. Stopgap also would end the ACA’s premium assistance and out-of-pocket cost subsidies and establish tax credits based on age and income.
3. Additionally, the proposal calls for a single level of insurance for individuals purchasing health plans on their own, rather than the ACA’s tiered plan system.
4. To incentivize insurers to remain on the exchange, Iowa proposed revisions to its reinsurance program to provide 85 percent coinsurance protection for claims between $100,000 and $3 million.
5. Timothy Jost, an emeritus professor at Lexington, Va.-based Washington and Lee University School of Law, told The Washington Post the proposal would not be legal. He said the government may grant exceptions through a 1332 waiver, but the process entails specific data, public engagement and steps that are not feasible before the 2018 open enrollment begins in November.
6. Iowa Insurance Commissioner Doug Ommen said he met with CMS Administrator Seema Verma last Wednesday to discuss the state’s individual market, which he told The Washington Post “is collapsing, so the normal rules don’t really fit the circumstance.”
7. The proposal comes a week before Iowa’s deadline for insurers to file 2018 ACA exchange participation plans.
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