Let Iowans buy into Medicaid as alternative to private insurance, Democrats say – DesMoinesRegister.com
Iowans who have trouble finding affordable health insurance on their own should be allowed to buy into the state’s Medicaid program, two Democratic legislators proposed Wednesday.
The idea was offered as an alternative to Iowa’s faltering market for individual health insurance, the kind people buy if they don’t have access to employer-offered policies or government programs.
“We’re trying to have a plan that’s affordable and works,” Rep. John Forbes of Urbandale told several dozen people gathered at Des Moines’ Central Library for a forum on health care.
Just one carrier has applied to offer individual insurance in Iowa for 2018. That company, Medica, has proposed raising premiums an average of more than 43 percent and has suggested that it still might pull out of the market.
Iowa’s insurance commissioner has proposed a stopgap plan to shore up the individual market for another year. Forbes and his colleague at Wednesday’s forum, Sen. Matt McCoy of Des Moines, said they favor that plan as “a Band-Aid,” but want a longer-term solution.
Under their plan, Iowans with moderate incomes could use Obamacare subsidies to help pay premiums for Medicaid as an alternative to private coverage.
McCoy said their proposal would include reversing Iowa’s 2016 decision to hire private managers to run the state’s Medicaid program. It would combine savings from that reversal with more than $300 million coming into the state annually in the form of Affordable Care Act subsidies to help moderate income Iowans buy private insurance, McCoy said.
“Then, you’ve got a lot of money to do a lot of good things with,” he added.
The idea would need approval from the Trump administration, which is actively trying to repeal the Affordable Care Act. It also would need backing from Republicans controlling the Iowa House, Senate and governorship.
That could be a tough sell.
“They’re in control. They’ve got the trifecta on us. Until 2018, that’s the reality,” Forbes told his Democratic-leaning audience.
Gov. Kim Reynolds’ spokeswoman, Brenna Smith, said earlier Wednesday that Reynolds would not take a stance on such a proposal before it’s written into a bill.
“Giving all Iowans access to health insurance should not be about politics,” Smith wrote in an email to the Register.
However, the governor reiterated her support for Insurance Commissioner Doug Ommen’s effort to shore up the current market for individual health insurance for 2018. Under that proposal, the federal government would spend about $80 million to set up a “reinsurance” program, which would help carriers shoulder costs of customers who use more than $100,000 per year in care.
Ommen’s proposal also would rejigger Affordable Care Act subsidies to give young people more help than they receive now and give older customers less help than they receive now. The goal would be to attract more young, healthy people to the pool. Iowa’s dominant health-insurer, Wellmark Blue Cross & Blue Shield, has said it would re-enter the state’s individual market if Ommen’s plan is enacted.
Smith said Reynolds hopes the federal government approves Ommen’s stopgap plan.
“The governor is also hopeful we will soon see a long-term solution that repeals and replaces Obamacare. The current system is unaffordable, unsustainable and collapsing right before our eyes,” she wrote.