Iowa’s New Health Non-Insurance Passes


Making A Comeback?

I will not pretend to be an expert on the new health insurance (non-insurance?) legislation passed this week by the Iowa legislature. Reading I have done on it seems to indicate that the legislature has just re-invented the crap policies that led to health insurance being one of the central issues of the 2008 election.

If you recall the situation leading up to 2008, people who had insurance would often be surprised that their policy did not cover what they went to the doctor for. Then they would find that insurance companies would then drop their coverage or would place riders on their policies that excluded coverage for their illnesses or claim that the insured’s problem was one of the dreaded “pre-existing conditions.”

Junk insurance these policies were called. One of the major focuses of the ACA was to make sure that when a customer purchased an insurance policy, that policy would cover the insured when the insured needed it to. Despite incredible push back from Republicans, the ACA did pass with real teeth to guarantee that when an insured expected their insurance policy to cover them it would.

Now it looks like Iowa is ready to take a giant step back to the dark days of spotty, unreliable coverage with a product that will be sold like insurance but is not insurance as we understand it.

Again, I am not an expert on this. From my perspective this is looking like the legislature is pulling a shell game on the rubes on the midway of health insurance. So we will turn to Charles Gaba at for a much more well informed critique.    Let me note here that if you live in Iowa and will be faced with making a decision on health insurance in the next year, you will want to read this article at least once. Here is a short excerpt:

The new coverage could offer relatively low premiums for young and healthy consumers, but people with pre-existing health problems could once again be charged more or denied coverage.

…Sen. Mark Chelgren, R-Ottumwa, defended the legislation, saying it is an example of how health care was provided before Congress enacted the Affordable Care Act.

Why yes, yes it is; that’s exactly the problem, Sen. Chelgren.

In short, starting in July:

  • If you have a pre-existing condition and earn less than 400% FPL (federal poverty level for income) , you can enroll in a heavily-subsidized ACA exchange policy.

  • If you’re healthy, awesome, you can enroll in a dirt-cheap junk plan! That is, until you’re diagnosed with something expensive and not covered. Then, if you earn more than 400% of the Federal Poverty Line, you shift to…

  • …if you have a pre-existing condition but earn more than 400% FPL? Well, you’ve just gone from being a little screwed in 2017 to kind of screwed in 2018 to completely and utterly screwed starting in 2019.

Gaba adds this comment by former Iowa Insurance Commissioner Susan Voss:

Former Iowa Insurance Commissioner Susan Voss said she’s concerned about the precedent of exempting an insurer from virtually all regulation. “It just doesn’t seem right,” she said in an interview.

The bill would declare that the new coverage would not technically be insurance, so it wouldn’t have to follow state or federal rules. Voss, a Democrat, scoffed at that. “If it walks like a duck and quacks like a duck, it’s a duck,” she said. “This is insurance.”

Voss agreed with the proposal’s backers that Wellmark and the Farm Bureau are strong Iowa organizations with long track records. But she said consumers should still be aware that if something goes wrong with the new type of coverage, they could not seek help from state regulators. For example, she said, the insurance division can now respond to complaints that an insurer is refusing to pay medical bills or has unfairly dropped a customer who developed a costly illness. Under the proposed arrangement, the division would have no oversight of the new health plans.

Please click at the link and read this full article. Iowa’s consumers have once again been the victims of a Republican film-flam designed to sabotage the ACA consumer protections. Be sure to bring this question up to your legislators as they campaign this fall. They have just reversed ten years of progress that has been hard fought to come by.

About Dave Bradley

retired in West Liberty
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