Iowa adults remain split over the Affordable Care Act, a new Iowa Poll shows. Fifty percent believe it has been mostly a failure, and 44 percent say it has been mostly a success.
Iowans who buy their own health insurance pleaded with the state’s insurance commissioner Saturday to rein in the largest proposed premium increase in state history, but he warned them his powers are limited.
Consumer Renee Welk of Des Moines was among those asking Commissioner Doug Ommen for help during a public hearing in downtown Des Moines.
“You could make a huge difference in this state and set an example that this is people over profits, that we are looking for what’s best for our whole state,” Welk said.
Ommen was taking comments about a proposed 57 percent premium increase for 2018 from Medica, the sole insurance carrier planning to sell individual health policies in Iowa for 2018. For many consumers, the increase would be even larger, because they’re now buying insurance from carriers with lower prices but would have to switch to Medica for next year.
Welk is among 72,000 Iowans facing skyrocketing premium costs for health insurance they buy on their own instead of via an employer or government program, such as Medicaid or Medicare. Many of the 72,000 have low enough incomes to qualify for federal subsidies under the Affordable Care Act. But about 28,000 of them don’t qualify for subsidies, so they have to pay the entire premium themselves.
Welk said she and her husband and two children now have an Aetna policy that costs $689 per month, but Aetna is pulling out of Iowa’s individual health insurance market. A comparable 2017 policy from Medica would be $1,221, she testified. If Ommen grants the 57 percent increase, the family’s monthly premium could top $1,900.
Welk told Ommen her family might consider buying a house in Minnesota and declaring residency there to get relief on their health insurance.
“Is that my first choice? No. But is it a choice that makes more sense than paying these increases? Yes,” she said.
Aetna and Wellmark Blue Cross & Blue Shield both plan to stop selling individual health insurance policies in Iowa next year, citing financial losses and unstable risks.
Wellmark has said it would re-enter the market if federal officials approve a “stopgap” plan proposed by Ommen. That plan would retool Affordable Care Act subsidies to try to encourage more young people to join the pool, and it would offer relief to carriers saddled with bills from members with extremely expensive health problems. But it would add thousands of dollars in out-of-pocket costs to many modest-income Iowans.
Ommen has said his plan would lead to substantially lower premiums than Medica has proposed for 2018. But while he’s waiting to hear if he’ll get federal approval for that plan, he’s moving ahead with the process of considering Medica’s proposed rates under the current rules.
Medica Vice President Geoff Bartsh takes the hotseat Saturday in a hearing on his company’s proposed 57 percent premium increase. Bartsh testified that the company needs the increase in order to serve as Iowa’s sole carrier offering individual health insurance for 2018. (Photo: Tony Leys/The Register)
Medica Vice President Geoff Bartsh testified Saturday his company needs the huge premium increase to handle Iowa’s risky individual health insurance market. The company originally proposed a 44 percent average increase in its Iowa premiums for next year. But it raised that level this month to 57 percent, citing President Donald Trump’s threats to block billions of dollars in Affordable Care Act payments to help insurers cover deductibles and copays for moderate-income customers.
Bartsh said Medica, which is a relatively small company based in Minnesota, was surprised to find itself as the only carrier willing to sell individual health policies in Iowa for next year.
“We’re very proud of our decision to stay in the market and offer an option for Iowans,” he said, adding that he understood how tough it would be for many consumers to pay the increased cost.
Nancy Barnett of West Des Moines, a small-business owner who buys her own coverage, told Ommen health care shouldn’t be covered by commercial insurers.
“When you stop to think about it, they’re making their profits on the backs of people who are sick,” she said. “It’s just not right.”
Barnett said she recognized Ommen’s hands are tied. She vented frustration at the lack of a national solution from Congress.
“They’ve had every opportunity to make the Affordable Care Act better, every opportunity to make it work, and they haven’t done it,” she said. “It’s shameful.”
Financial experts who work for Ommen or for an independent actuarial firm have concluded Medica’s rate proposal is justified. The experts wrote that the Minnesota based carrier has been losing money in Iowa, where it currently has just a portion of the individual insurance market. It would need substantially higher rates in order to take on the entire market, they wrote.
Ommen will make a decision on the proposal within a few weeks. He told consumers that under the law, he can only judge the rates on whether they’re justified to pay out medical claims and cover a carrier’s risks.
“That’s frankly about all the authority I do have,” said Ommen, who is a Republican. “I’ve said it before, but Congress has got to fix this.” Several people in the audience applauded.
If the proposed rate increase is rejected, Medica could decline to offer individual insurance in Iowa, which would leave tens of thousands of consumers stranded.
Saturday’s two-hour hearing drew a few dozen people to a conference room at the Mercy College of Health Sciences. Other consumers commented via video from around the state.
Besides the Medica proposal, the hearing also considered premium increases proposed by Wellmark for about 73,000 customers who have hung on to “grandfathered” plans they bought before the Affordable Care Act took effect in 2014. Wellmark wants to raise those premiums by an average of 9 percent to 14 percent, depending on the plan. The company cites fast-rising prices and increased use of health care services and medications. State and private experts determined the Wellmark rate increases could be justified.
But several Wellmark customers asked Ommen to hold the line on the Wellmark premiums, which have risen year after year.
“Listen to the people in this room, Mr. Commissioner. These are real people, real lives,” said Steve Gray, who farms near the town of Hawkeye and has a longstanding Wellmark policy. “Take that into consideration. Tell them no. Enough is enough.”
Consumers who didn’t attend the hearing can still make written comments via the Insurance Division’s website.
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