Come 2018, Iowa has the potential threat of losing health care provider options within their exchange for a significant number of residents. Now, the Iowa insurance commission is requesting a Section 1332 waiver from the Department of Health and Human Services to help the state develop a new type of marketplace.
Some 72,000 Iowa residents now receive ACA compliant healthcare plans. However, two insurers have said they will not provide coverage in 2018, and the state expects the final two will drop out, leaving the state with no insurance carriers for 2018. Iowa’s plan to rectify the situation involves a “stopgap” that would entail having insurers offer an ACA silver-rated plan that would cover essential health benefits and state-mandated benefits. The request is for $352 million in federal funds. Without this assistance (and Iowa’s proposed single standardized plan), 99 counties throughout Iowa risk having no health insurance exchange options come next year.
Iowa isn’t alone. Many states throughout the country have endured major insurer withdrawals from the ACA’s exchanges, leading to minimal competition in certain markets. There are 47 counties in four states – Kansas, Missouri, Ohio and Washington — in which there is no marketplace coverage in place for 2018. At least two bills have been proposed in Congress to address this issue, but neither apparently is being discussed while the Senate GOP is debating its ACA repeal and replace proposal.
