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Iowa health insurance exchange

Four insurers on Iowa exchange; Wellmark sits out again

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Enrollment didn’t take off in Iowa during 2014, but consumers will have soon have another opportunity to take advantage of the coverage options available through the health insurance marketplace.

The second open enrollment period begins Nov.15, and there is good news for Iowa consumers. The slate of participating insurers is stable from last year, and announced rate increases will affect less than two percent of consumers.

In addition, shopping and enrolling on HealthCare.gov will be easier. The federal site used by Iowa residents will feature a streamlined application process will apply to four of five people using the marketplace. Technical improvements mean the site will be faster and easier to navigate.

Insurers in Iowa’s marketplace

Four insurers will again sell policies through the Iowa marketplace in 2015: Avera Health Plans, CoOportunity Health, Coventry, and Gundersen Health Plan. CoOportunity is a consumer operated and oriented plan, formed with funding through the Affordable Care Act. Wellmark, the largest insurance carrier in Iowa, will not join the marketplace in 2015.

98 percent not affected by rate increases

The Iowa Department of Insurance approved rate increases for the two insurers that offer marketplace plans statewide, as well as for Wellmark plans that are only sold off market. However, Nick Gerhart, state insurance commissioner, said less than two percent of the state’s residents — about 50,000 people —would be affected by the increases.

Marketplace plans from CoOportunity are going up an average of 19 percent, while plans sold by Coventry are increasing 8.7 percent on average.

The Iowa Department of Insurance website includes selected rate information, including premiums for silver plans available on and off the marketplace. Information is arranged by region (rating area) and provided for five age points. This information gives consumers a good sense of premium costs as they plan and prepare for 2015 enrollment. Complete information — including subsidy amounts and premiums for all marketplace plans — will be visible on HealthCare.gov on or shortly before Nov. 15 when open enrollment begins.

2014 enrollment metrics

In total, 29,163 people enrolled in qualified health plans (QHPs) during 2014 open enrollment, and an additional 36,891 people qualified for Medicaid or the Children’s Health Insurance Program (CHIP).

Just 11.1 percent of Iowa residents eligible to enroll through the marketplace did so in 2014. Iowa tied with neighboring South Dakota for the lowest percentage of eligible enrollees signing up. A Kaiser Health News article attributes the low enrollment in both states to Wellmark Blue Cross & Blue Shield’s decision against participating in the states’ marketplaces rather than a boycott of the Affordable Care Act.

A U.S. Department of Health and Human Services report showed the average, post-subsidy premium for Iowa consumers was $108 per month. The national average in states using HealthCare.gov $82 per month after subsidies.

Twenty-six percent of Iowa residents selected a bronze plan (20 percent nationally), 57 percent selected a silver plan (65 percent nationally), 12 percent selected a gold plan (9 percent nationally), 4 percent selected a platinum plan (5 percent nationally) and 2 percent selected a catastrophic plan (2 percent nationally). Twenty-six percent of Iowa enrollees were between the ages of 18 and 34.

Iowa’s approach to the marketplace and Medicaid expansion

Iowa operates a partnership exchange 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. The federal government manages the exchange website and call center, and funds the Navigator program.

Iowa is occasionally mentioned as a state that may transition to a different model for its exchange. In February 2014, Gov. Branstad floated the idea of a regional exchange in conjunction with South Dakota, Nebraska and Kansas. Bills to convert to a state-run exchange were introduced in Senate committees in both 2013 and 2014, but neither advanced.

In December 2013, 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.

Iowa health insurance exchange links

HealthCare.gov
800-318-2596

Iowa Insurance Division: State Partnership Exchange Plan Management

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 / consumer.advocate@iid.iowa.gov