Kim Reynolds’ Failure Will Cost Thousands of Iowans’ Their Health Insurance

Iowa Governor Kim Reynolds announced this afternoon that Iowa had failed to obtain a waiver on Iowa’s stopgap health insurance plan yet from the Trump Administration and was withdrawing their proposal. About 70,000 Iowans are on the state’s individual market healthcare exchange, which will feature only one provider in 2018, and that provider plans on increasing their premiums 57%. The state estimated today that between 18,000 and 22,000 Iowans could leave the market in 2018. They predicted that the healthiest Iowans would leave first, leading to a “death spiral” in the market.

Reynolds’ stopgap plan certainly wasn’t a perfect one, but it would have stabilized the individual market through the next year and kept Wellmark on the exchange. Throughout her press conference today, Reynolds and insurance commissioner Doug Ommen put the blame on Obamacare.

“Obamacare has driven out consumer choice and competition, as we’ve seen eight of nine health carriers exit Iowa’s individual health insurance market,” Reynolds said. “The rules for receiving a 1332 waiver from the federal government, they were developed by Obamacare. Obamacare gives states very little room for flexibility.”

(You can watch Reynolds’ entire press conference here)

Republicans hold power at all levels of government in Iowa, Congress and the White House. However, Reynolds placed the blame on Congress’ failure to repeal Obamacare, though she noted that Iowa’s federal Republican legislators voted for the repeal.

“We need Congress to repeal and replace,” Reynolds asserted. “They need to do something to give states more flexibility.”

A bipartisan plan to stabilize the individual markets, but also keep large parts of the Affordable Care Act in place – the Alexander-Murray bill – has not been taken up by Republican leadership. Reynolds noted that the Alexander-Murray bill was an option without signaling support or opposition to it, but added that it was simply taking too long to move through Congress to have an impact on Iowa’s current situation.

The Washington Post reported a few weeks back that President Donald Trump had personally intervened with the Department of Health and Human Services to kill Iowa’s stopgap plan. It’s not entirely clear what role that played in today’s decision (nor will we likely ever know for sure), though Reynolds said she had spoken to Trump about the stopgap plan on the phone last week and that Iowa had been working closely with the Centers for Medicare and Medicaid on the plan. Reynolds claimed that what eventually killed the plan was the ACA’s inflexibility, though other states have been able to obtain waivers from the federal government on their marketplaces.

Notably, Reynolds and other Iowa Republicans were able to work their connections with Trump to stave off potential changes to the Renewable Fuel Standard from the EPA last week, but when it came to ensuring Iowans had affordable health insurance, they could not.

Several Democratic legislators, including Senator Matt McCoy and Representative John Forbes, have been working this year to come up with a Medicaid public option for Iowa that’s run by the state, which could offer affordable healthcare to people left in the lurch next year. They’re expected to detail their plan in further depth this week or next, and introduce it during the next legislative session. With Republicans in charge there it likely won’t go anywhere, but could provide a real plan for Democrats to run on in 2018.

by Pat Rynard
Posted 10/23/17