Report of 'stopgap' insurance proposal's death is premature, Iowa officials say

Iowa officials said Thursday evening they still hadn’t heard whether the Trump administration will approve or deny a “stopgap” plan to stabilize the state’s health insurance market, despite a national report that the president told his administrators to reject it.

The Washington Post reported that President Trump told a top human-services administrator in August to reject Iowa’s plan. The proposal was made by Iowa Insurance Commissioner Doug Ommen, who is a fellow Republican. It would redirect Affordable Care Act money in a way that Ommen says would encourage more young, healthy Iowans to buy individual insurance policies and would ease risks to insurance carriers.

The Post, citing anonymous sources, said the president told Seema Verma, who oversees health care programs, to reject the Iowa plan. The story noted several other ways in which the Trump administration has blocked steps to shore up markets functioning under the Affordable Care Act, which the administration wants to repeal.

Ommen’s spokesman, Chance McElhaney, said Thursday evening that Iowa had not received word about whether the Trump administration would approve or reject the plan. He said the insurance division is still hoping to get approval soon, so it could implement the proposal before Nov. 1, when Iowans are to start signing up for 2018 coverage.

The issue affects about 72,000 Iowans who buy their own health insurance, instead of obtaining it via an employer or government program, such as Medicare or Medicaid. Just one carrier, Medica, plans to sell individual policies in Iowa under current Affordable Care Act rules. Medica intends to raise premiums by an average of nearly 58 percent.

Most of the affected people would be shielded from those increases, because they qualify for Affordable Care Act subsidies that pay much of their premiums. But about 28,000 of them make too much money to qualify for the subsidies, so they would have to shoulder the entire cost of the coverage. Ommen has predicted more than 20,000 of them would drop their insurance instead.

Critics of Iowa’s stopgap plan say it would hurt many moderate-income Iowans, because it would redirect Obamacare money that now is being used to help them cover thousands of dollars in deductibles and co-pays. But supporters, including the state’s Republican governor and U.S. senators, have urged the Trump administration to approve the stopgap plan as a temporary way to stabilize Iowa’s shaky health insurance market until Congress can pass longer-term changes.

Gov. Kim Reynolds’ office issued a statement Thursday evening indicating she was still hoping the plan would be approved.

“The federal government recently deemed Iowa's Stopgap Measure application complete and is currently conducting a 30 day public comment period that ends Oct. 19,” the statement said. “We are working with the White House and (the Centers for Medicare and Medicaid Services) to approve Iowa's Stopgap Measure in a timely manner to relieve 72,000 suffering Iowans from Obamacare.”

A spokeswoman for Sen. Chuck Grassley also expressed continuing hope for the proposal. “Based on the status of the request at this point, according to state agency officials, Sen. Grassley continues to express his support to (the Department of Health and Human Services) for approval of Iowa’s state waiver,” she wrote in an email to the Register.