Affordable Iowa health insurance

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Iowa health insurance exchange

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Iowa health insurance exchange

By
healthinsurance.org contributor
July 24, 2014

Obamacare enrollment in Iowa has ended for 2014. However, people who get married or divorced, change jobs, have a child or experience another qualifying event may be eligible for a special enrollment period.

Enrollment for Medicaid and the Children’s Health Insurance Program (CHIP) continues throughout the year. Individuals who don’t have health insurance that provides “minimum essential coverage” may have to pay a penalty: $95 or one percent of income, whichever is greater.

Open enrollment for 2015 coverage through the marketplace begins Nov. 15.

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

Among Iowa residents selecting a QHP, 84 percent qualified for financial assistance, compared to 85 percent nationally. A report released in June by the U.S. Department of Health and Human Services showed the average monthly premium, after subsidies, for Iowa consumers was $108. Among states using the federal marketplace, the average post-subsidy premium was $82.

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 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.

Four insurers sold individual and family coverage for 2014 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.

Both CoOportunity and Coventry requested rate increases for 2015: CoOportunity is requesting an average increase of 14.3 percent, and Coventry is requesting an average increase of 8.7. Wellmark, the largest insurance carrier in Iowa, announced it will not join the marketplace in 2015.

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