With Health-Insurance Marketplace Rates To Come, Preparing For January 1

CEDAR RAPIDS, Iowa - As October 1st looms for the start of Iowa's six-month enrollment period with the state's health insurance marketplaces (also referred to as "exchanges"), the prices for coverage are still due to come out next week.

Iowa Insurance Commissioner Nick Gerhart told the Des Moines Register on Thursday that Iowans who purchase insurance on the government's upcoming marketplaces will likely see lower prices than people in many other states.

Yet until those prices are made public, speculation reigns.

Dr. Keith Mueller, of University of Iowa Public Health, has spent years researching the Affordable Care Act since its 2010 passage in Congress.

"In Iowa, it's hard to predict," said Mueller of the imminent pricing information to be made public. "Most of the predictions in Iowa are that the rates would be a little higher in the exchange because for most of the people coming in, the insurance carriers would anticipate higher usage, especially in the first year if they've not been getting adequate care."

Here are the critical dates for Iowans considering health insurance under the marketplace:
- Next Week: The Iowa insurance commissioner will release the marketplace rates.
- October 1: Start of the open enrollment period.
- December 15: Deadline to enroll for coverage that starts on January 1, 2014.
- January 1, 2014: Earliest date of marketplace insurance.
- March 31, 2014: Open enrollment period to register ends.

Mueller said he doesn't expect a major influx of people signing up right away on October 1 but, as the autumn moves along, it should pick up.

"They don't need to pull the trigger right away on October 1," said Mueller. "Think in terms of 'where do I get my medical care?' so that, when I do start looking at different plans, see who they include in their networks."

Eastern Iowa hospitals are also anticipating any shifting demands for when the service starts on the new marketplace at the new year.

"We are preparing for more clinic visits and that's the intent, really, in keeping people healthy and engaging them in their health care and have more of those clinic visits," said Lori Weil, Regional Director - Continuum of Care with UnityPoint Health (St. Luke's Hospital) in Cedar Rapids.

Tim Charles, President & CEO of Mercy Medical Center, said their facilities are "really prepared" for the demand.

"We believe individuals want value and what value is the highest quality care at the lowest cost possible," said Charles. "That's the intention of health care reform."

Mueller agrees that it would likely be clinics that would see a higher volume of patients once the coverage kicks in.

"Typically, someone who does not have health insurance and is afraid of seeking primary care and end up in an emergency room because they just have to get care," said Mueller. "Hopefully, those people will come to a primary care provider now that they have coverage."

Medicaid already covers many low-income Iowans while Medicare handles many who are age 65 or older.

As for who is eligible, the website www.healthcare.gov allows a user to enter their information to see what options are available.

Some examples for a health insurance shopper living in Iowa:

- Male, 28, single, no current coverage. Income threshold: $48,283.
- Female, 38, family of four, has coverage. Income threshold: $98,935
- Male, 62, family of two, veteran and with pre-existing conditions. Income threshold: $65,167.

For those "above" the threshold: options include "The Health Insurance Marketplace" but without any discounts.

For those "below": Medicaid may be an option along with discounted marketplace rates.


Visit Insert this html code: Health Care.gov for more information on eligibility.
facebook twitter email alerts you tube hooplanow

 close  don't show again