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Beginning Phase for Iowa's Health Insurance Exchange Under Way

IOWA CITY, Iowa Iowa's Medicaid ranks could swell by 25 percent once health care reform changes are implemented.

Current rules require that low-income Iowans also have a qualifying factor, such as a disability or pregnancy, to be eligible for Medicaid.

Reform measures could add 80,000 to 100,000 Iowans mostly single adults or childless couples who earn below 133 percent of the federal poverty level and don't have those qualifiers, said Jennifer Vermeer, Iowa Medicaid Enterprise director.

Vermeer and Julie McMahon of the Iowa Department of Public Health spoke to about 40 people Tuesday, Dec. 14, at the Iowa City Public Library as part of the health department's efforts to gather comments on the state's development of a health benefits exchange.

The state-based exchanges are intended to make purchasing health insurance easier by providing individuals and businesses with "one-stop-shopping" where health insurance coverage can be compared and purchased.

Under the Affordable Care Act, states must have an operational exchange by Jan. 1, 2014, or the federal government will operate an exchange for the state.

The exchange will use an Internet-based system to compare insurance plans.

Medicaid and the Affordable Care Act are intertwined because anyone applying for health insurance under the state's exchange would also see if they qualify for Medicaid, Vermeer said.

Subsidies will be available for other Iowans who cannot afford to purchase health insurance.

Three components to the system have similar names, but different purposes.

An insurance information exchange is a health insurance information clearinghouse. The health benefit exchange the topic of Tuesday's meeting is the one-stop shopping venue to compare and enroll in health insurance plans. A health insurance information exchange allows electronic health records data to be securely shared among health care providers.

Some at the meeting were concerned about that data being shared; one of the issues that the state is examining.

Other issues include outreach to rural residents, African Americans, Latinos and other people who might not have access to needed information and having "navigators" available to help people with disabilities and others understand the new system.

"We need to reach out in whatever venue we can," McMahon said.

Ryan Saul, agency sales manager for Professional Insurance Planners and Consultants of Cedar Falls, suggested that Iowa insurance brokers and agents who provide navigation services have a compensated role in the system.

Andrew Cannon of the Iowa Policy Project urged planners to consider using an independent agency to operate the exchange to avoid conflicts of interest.

He also encouraged having a variety of insurance plans, from small to national, in addition to the "dominant one in the state."

Sen. Joe Bolkcom, D-Iowa City, said he hopes to have the governance structure of the exchange in place during the upcoming legislative session.

The health department will have the following meetings to gather comments:

* Waterloo Waterloo Public Library December 20 9:30 am to 11:30 am
* Sioux City Wilbur Aalfs Library December 21 9:30 am to 11:30 am
* Ottumwa Ottumwa Public Library December 22 9:00 am to 11:00 am

For more information, check the Iowa Department of Public Health website.

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