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Iowa Tries to Form New Marketplace For Health Insurance

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DES MOINES, Iowa - Consumer groups are increasing the pressure on Gov. Terry Branstad to allow Iowa to begin setting up an online marketplace for health insurance now that President Barack Obama's re-election has cleared the way for the new federal health care plan to go into effect.

Under the new Affordable Care Act, states have until Friday to notify the federal government whether they will set up a health insurance exchange. Individuals and small businesses would use the exchange to shop for health insurance among competing private plans and receive subsidies.

The law. intended to make health coverage available to most of the uninsured, calls for legislation to be enacted before Jan. 1, or the government will step in to establish a federally operated exchange. About 500,000 Iowans are expected to participate in an exchange.

Branstad was among a number of Republican governors who has delayed making preparations, hoping the law would be rolled back if Republican Mitt Romney was elected president. Seventeen states and the District of Columbia have taken steps to set up an online marketplace for the new system, while about 10 have decided not to do so.

A state working group will attempt to meet the deadlines next week, said Branstad spokesman Tim Albrecht.

The group, including officials from the Iowa Department of Public Health, Department of Human Services, Insurance Division and Governor's Office, has been managing the state's efforts for an exchange, Albrecht said.

"Gov. Branstad continues to believe that if Obamacare mandates an exchange be built in every state, an exchange built by Iowa, for Iowa, is better than a one-size-fits-all exchange built by bureaucrats in Washington," Albrecht wrote in an email.

"However, the federal government has not clearly outlined what is expected with regard to an exchange, and we await word on any constraints that may hinder states in their efforts to construct a state-specific exchange," Albrecht said.

Consumer group officials demanded that Branstad allow them input into the new system.

"If you're talking about setting up a health care system that so many Iowans are going to use ... it's imperative to talk to consumer groups and the people who represent them and the public in general," said Anthony Carroll, an official of the American Association of Retired People.

The AARP is one of 35 organizations, including labor unions and community groups, that want to be involved.

Sen. Jack Hatch, D-Des Moines, said he hopes Obama's re-election has forced Branstad's hand.

"I have proposed for the past two years the creation of an insurance exchange and he has refused to meet with me in a bipartisan effort to start just the discussion of what an exchange would look like," Hatch said.

Hatch, who chairs the Iowa Senate Health and Human Services Budget Subcommittee, said the delay may have left Iowa without adequate time to choose plans that would best serve state residents.

However, a spokesman for U.S. Department of Health and Human Services said some leeway may be allowed after Friday's deadline for states that have procrastinated.

"After declaring their intentions by Friday, states can take another month, until mid-December, to submit detailed blueprints, said spokesman Fabien Levy.

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