By Carla Anderson
March 7, 2014
The number of Iowans who selected a health plan increased to 11,788 as of Feb. 1 according to the latest enrollment report issued by the U.S. Department of Health and Human Services (HHS). An additional 25,566 people were deemed eligible for Medicaid or the Children’s Health Insurance Program (CHIP).
Eighty-three percent of Iowa residents selecting a private health plan qualified for financial assistance, compared to 82 percent nationally. Twenty-one percent of Iowans selected a bronze plan (19 percent nationally), 57 percent selected a silver plan (62 percent nationally), 15 percent selected a gold plan (12 percent nationally), 6 percent selected a platinum plan (7 percent nationally) and 1 percent selected a catastrophic plan (1 percent nationally). Twenty-four percent of health plan enrollees were between the between the ages of 18 and 34, while 37 percent were between the ages of 55 and 64.
Enrollment for private insurance in 2014 continues through March 31. Individuals who remain uninsured after March may face a tax penalty of $95 or one percent of income, whichever is greater. Enrollment for Medicaid or CHIP continues throughout the year.
Iowa’s health insurance marketplace is a partnership with the federal government. Iowa residents use the federal marketplace, HealthCare.gov, to compare and purchase coverage. The state is responsible for plan management, consumer assistance, and Medicaid eligibility determination. Iowa’s plan management functions include selecting and monitoring the qualified health plans (QHP) that offer policies on the exchange. Iowa’s role in consumer assistance is education and outreach, coordinating the in-person consumer assisters, and overseeing the Navigator program. Under the current partnership model, the federal government manages the exchange website and call center, and funds the Navigator program.
Iowa plans to transition to a state-run model by 2016. In the Iowa Senate, a bill authorizing a state-run marketplace is currently under consideration by the Commerce Committee. Gov. Terry Branstad has suggested the idea of a multi-state exchange, in conjunction with South Dakota, Nebraska and Kansas. Partnering with other states would save money according to Branstad.
In mid-December, Iowa received a waiver for its alternative to the ACA’s Medicaid expansion. Under a program called the Iowa Health and Wellness Plan, some very low-income residents would be enrolled in a state-run health plan and, in some cases, be required to pay modest premiums. Other residents with slightly higher incomes would purchase insurance through the marketplace, with premiums paid by the federal government.
Four insurers are selling individual and family coverage through the Iowa marketplace: Avera Health Plans, CoOportunity Health, Coventry, and Gunderson Health Plan. CoOportunity is a new consumer operated and oriented plan, formed with funding through the Affordable Care Act. Coventry and CoOportunity Health are selling policies state-wide, while Avera and Gunderson sell policies in select regions.
According to an HHS report, the average cost for a bronze plan — the lowest-cost option — in Iowa is $212 a month. The national average for a bronze policy is $249 a month.
According to HHS, about 225,000 of Iowans (10 percent of the population) are uninsured.
State Exchange Profile: Iowa
The Henry J. Kaiser Family Foundation overview of Iowa’s progress toward creating a state health insurance exchange.
Consumer Advocate Bureau
Provides consumers with assistance in navigating the health care system, assistance programs, and other issues related to health insurance benefits.
1-877-955-1212 / firstname.lastname@example.org